Intravesical Ectopic Pregnancy in Vesicouterine Fistula Patient: A Very Rare Case Report and Literature Review.

Abstract

Vesicouterine fistula (VUF) is a rare form of urogenital fistula, accounting for approximately 4% of cases. It commonly arises as a complication of uterine interventions, especially previous cesarean sections (C-sections). Intravesical ectopic pregnancy complications are infrequent. We discuss a 39-year-old female with severe lower abdominal pain spreading to the flank, dysuria, hematuria, and urinary hesitancy one week after laparotomy for fetal demise at 17-18 weeks of gestation. A dead fetus in the urinary bladder along with the VUF was revealed in the imaging. The surgical operation identified a fistula between the posterior bladder wall and the lower uterine segment. Fetus evacuation and fistula repair were performed with symptom resolution achieved. A literature review was conducted and nine articles were extracted. These articles discussed the risk factors and complications of VUF. The articles, selected for relevance and quality, highlighted cesarean sections as the most common risk factor, with hematuria being the most frequent complication. Only a small number of cases had fetal migration into the bladder documented, showcasing its rarity. This case represents a rare complication of VUF: intravesical ectopic pregnancy into the bladder. Surgical intervention led to favorable outcomes and is consistent with findings in the reviewed literature. The rare complication of VUF such as intravesical ectopic pregnancy requires proper diagnosis and treatment. This case emphasizes the importance of surgical management in achieving successful outcomes for VUF and its complications.