Fistulectomía vaginal exitosa en un caso de fístula vesicovaginal obstétrica por embolización de arterias uterinas

Abstract

de arterias uterinas; cesárea; histerectomía. Abstract BACKGROUND: Obstetric genitourinary fistulas can cause as a complication of uter- ine artery embolization due to necrosis of the uterus and/or bladder. Vaginal surgical treatment is a less invasive option with success rates of up to 84.12%. CLINICAL CASE : A 40-year-old woman who came with a pregnancy of 35 5/7 weeks and placenta accreta, which was managed with uterine arteries embolization and obstetric hysterectomy after caesarean section. At 3 weeks she had vaginal urine loss; by physical examination and with support of dye test, cystoscopy and retrograde cys-tography, obstetric vesicovaginal fistula was diagnosed. After the improvement of the inflammatory process, vaginal fistulectomy was performed with modification of the Latzko technique. Its postoperative evolution was satisfactory and without recurrence of the fistula during the follow-up in the outpatient clinic. CONCLUSION: This is the fifth case of post-embolization bladder necrosis reported in the literature. The favorable resolution of this case allows us to conclude that vaginal fistulectomy is a viable and safe alternative in the surgical treatment of this type of obstetric fistulas.