Post caesarean vesicouterine fistula: A rare entity

Introduction: Vesicouterine fistulas (VUF) are an uncommon and pathological connection between the uterus and the bladder. Although rare, they are usually related to caesarean section. Case Report: A 28 year old female, P 2+1, consulted in gynecology OPD for a 5 years history of episodes of painless cyclical hematuria (menouria) every month that started immediately after her last caesarean section. Her past obstetric history was significant for one previous caesarean section. After admission and confirming the diagnosis of vesicouterine fistula by cystoscopy and CT scan pelvis, surgery was done. The surgical repair included a fistulectomy with primary uterine and bladder repair followed by omental flap interposition. The recovery was uneventful with no recurrence of symptoms. Conclusion: This case highlights the fact that although vesicouterine fistulas are uncommon, but the diagnosis should always be on top of mind in patients presenting with menouria and/or urinary incontinence associated with a history of caesarean section.