title: Unique complication of a Shirodkar cerclage: remote formation of a vesicocervical fistula in a patient with the history of cervical cerclage placement: a case report and literature review.
abstract: BACKGROUND
  Cervical cerclage placement is an accepted treatment for cervical insufficiency and recurrent second-trimester pregnancy loss. The most commonly described complications of cerclage include rupture of fetal membranes, intra-amniotic infection, endometritis, and peripartum bleeding. We present a unique case of a vesicocervical fistula formation remote from cerclage placement.
  
  
  METHODS
  A vesicocervical fistula was diagnosed in a 51-year-old patient who presented with a chief complaint of vaginal bleeding. The fistula was found on cystoscopic examination after the extrusion, from the cervix, of Mersilene tape from a Shirodkar cerclage placed 13 years earlier for management of cervical insufficiency.
  
  
  CONCLUSIONS
  Although the presented condition was managed conservatively, one should discuss remote formation of urogenital fistulae as a rare complication of cervical cerclage at the time of informed consent.
authors: Department of Obstetrics and Gynecology, Geisinger Medical Center, Danville, PA, USA. somadueke@gmail.com
authors: Obianuju Sandra
authors: OS
authors: Madueke-Laveaux
authors: Raisa
authors: R
authors: Platte
authors: Deborah
authors: D
authors: Poplawsky
mesh_terms: D023802:Cerclage, Cervical / Q000009:adverse effects*; D005260:Female; D005402:Fistula / Q000209:etiology* / Q000628:therapy; D006801:Humans; D008875:Middle Aged; D013537:Sutures / Q000009:adverse effects*; D001747:Urinary Bladder Fistula / Q000209:etiology* / Q000628:therapy; D002577:Uterine Cervical Diseases / Q000209:etiology* / Q000628:therapy