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Combined conservative surgical and medical treatment of a uterocutaneous fistula.

Abstract：

:Uterocutaneous fistula is a rare complication that may follow cesarean section. Herein is described a rare case of uterocutaneous fistula. The patient, a 28-year-old woman with a history of American Society for Reproductive Medicine stage IV endometriosis (Douglas pouch obliteration), underwent a cesarean section at 25 weeks of gestation (twin pregnancy). Postoperatively, the patient returned to the emergency service because of the appearance of pus through the cesarean section abdominal scar, and was treated for a subcutaneous abscess. Because drainage continued, the presence of a uterocutaneous fistula was suspected. Magnetic resonance imaging confirmed this diagnosis. Hysteroscopy clearly revealed the uterine neck of the fistula tract. Leuprolide acetate (gonadotropin-releasing hormone agonist) deposit suspension was administered subcutaneously monthly for 6 months. Surgery via laparoscopy and laparotomy was performed. This combined medical and conservative surgical treatment was successful. At 6-month follow-up, hysteroscopy revealed a normal uterine cavity. We conclude that magnetic resonance imaging and hysteroscopy are helpful in diagnosis of uterocutaneous fistula. Conservative surgical treatment associated with medical therapy can be an efficient procedure in women who desire subsequent pregnancies.

journal_name

J Minim Invasive Gynecol

journal_title

Journal of minimally invasive gynecology

authors

Thubert T,Denoiseux C,Faivre E,Naveau A,Trichot C,Deffieux X

doi

10.1016/j.jmig.2011.10.010

subject

Has Abstract

pub_date

2012-03-01 00:00:00

pages

244-7

issue

2

eissn

1553-4650

issn

1553-4669

pii

S1553-4650(11)01332-X

journal_volume

19

pub_type

杂志文章

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