Abdominal hysterectomy due to uterine rupture causing bilateral ureterovaginal fistula: A rare case report

Ureterovaginal fistula (UVF) is defined as abnormal communication between ureter and vagina. Although documented after radical hysterectomy, post radiation and retained pessary incidence of bilateral UVF is still very rare. We have documented a case report of a multipara woman presented with persist...

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Main Authors: Amitayu Jana, Krishnendu Maiti
Format: Article
Language:English
Published: Wolters Kluwer Medknow Publications 2024-05-01
Series:Annals of Medical Science and Research
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Online Access:https://journals.lww.com/10.4103/amsr.amsr_44_23
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author Amitayu Jana
Krishnendu Maiti
author_facet Amitayu Jana
Krishnendu Maiti
author_sort Amitayu Jana
collection DOAJ
description Ureterovaginal fistula (UVF) is defined as abnormal communication between ureter and vagina. Although documented after radical hysterectomy, post radiation and retained pessary incidence of bilateral UVF is still very rare. We have documented a case report of a multipara woman presented with persistent urinary leakage following an emergency hysterectomy for obstructed labor. After evaluation with imaging there was bilateral hydroureterophrosis with dense purulent collection mixed with contrast in the vesicular area with lower end of ureter draining in the vaginal vault with preserved renal function. During exploration both ureters were dilated. Instillation dye in both ureters showed extravasation in vagina. After ligating distal ends modified Lich-Gregoir technique done over double J (DJ) stents. DJ removed after 3 months. Bilateral UVF is only 5%–10% of all ureteric injury. Aggressive blind clamping, excessive hemorrhage, distorted anatomy, malignancy and surgeons experience play a crucial role. Obstetric cause is the prime factor. Preventing measures like proper screening of antenatal patients, early detection of high-risk pregnancy, supervised caesarean section should be taken to avoid ureteric injuries
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institution Kabale University
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spelling doaj-art-4ed4ca2b4eb74cda8dd763c0d63ddcb52025-08-20T03:36:14ZengWolters Kluwer Medknow PublicationsAnnals of Medical Science and Research2949-785X2949-78682024-05-013212813010.4103/amsr.amsr_44_23Abdominal hysterectomy due to uterine rupture causing bilateral ureterovaginal fistula: A rare case reportAmitayu JanaKrishnendu MaitiUreterovaginal fistula (UVF) is defined as abnormal communication between ureter and vagina. Although documented after radical hysterectomy, post radiation and retained pessary incidence of bilateral UVF is still very rare. We have documented a case report of a multipara woman presented with persistent urinary leakage following an emergency hysterectomy for obstructed labor. After evaluation with imaging there was bilateral hydroureterophrosis with dense purulent collection mixed with contrast in the vesicular area with lower end of ureter draining in the vaginal vault with preserved renal function. During exploration both ureters were dilated. Instillation dye in both ureters showed extravasation in vagina. After ligating distal ends modified Lich-Gregoir technique done over double J (DJ) stents. DJ removed after 3 months. Bilateral UVF is only 5%–10% of all ureteric injury. Aggressive blind clamping, excessive hemorrhage, distorted anatomy, malignancy and surgeons experience play a crucial role. Obstetric cause is the prime factor. Preventing measures like proper screening of antenatal patients, early detection of high-risk pregnancy, supervised caesarean section should be taken to avoid ureteric injurieshttps://journals.lww.com/10.4103/amsr.amsr_44_23bilateral ureterovaginal fistula (uvf)computed topography (ct)double j (dj)intrauterine fetal death (iufd)per-urethral catheter (puc)
spellingShingle Amitayu Jana
Krishnendu Maiti
Abdominal hysterectomy due to uterine rupture causing bilateral ureterovaginal fistula: A rare case report
Annals of Medical Science and Research
bilateral ureterovaginal fistula (uvf)
computed topography (ct)
double j (dj)
intrauterine fetal death (iufd)
per-urethral catheter (puc)
title Abdominal hysterectomy due to uterine rupture causing bilateral ureterovaginal fistula: A rare case report
title_full Abdominal hysterectomy due to uterine rupture causing bilateral ureterovaginal fistula: A rare case report
title_fullStr Abdominal hysterectomy due to uterine rupture causing bilateral ureterovaginal fistula: A rare case report
title_full_unstemmed Abdominal hysterectomy due to uterine rupture causing bilateral ureterovaginal fistula: A rare case report
title_short Abdominal hysterectomy due to uterine rupture causing bilateral ureterovaginal fistula: A rare case report
title_sort abdominal hysterectomy due to uterine rupture causing bilateral ureterovaginal fistula a rare case report
topic bilateral ureterovaginal fistula (uvf)
computed topography (ct)
double j (dj)
intrauterine fetal death (iufd)
per-urethral catheter (puc)
url https://journals.lww.com/10.4103/amsr.amsr_44_23
work_keys_str_mv AT amitayujana abdominalhysterectomyduetouterinerupturecausingbilateralureterovaginalfistulaararecasereport
AT krishnendumaiti abdominalhysterectomyduetouterinerupturecausingbilateralureterovaginalfistulaararecasereport