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Uretero-Uterine Fistula: Delayed Presentation After Ureteral Reimplantation for Vesicoureteral Reflux.

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Citation: Female Pelvic Medicine & Reconstructive Surgery. 21(4):e36-8, 2015 Jul-Aug.PMID: 25730434Institution: MedStar Washington Hospital Center | MedStar Washington Hospital Center | MedStar Washington Hospital Center | MedStar Washington Hospital CenterDepartment: Obstetrics and Gynecology/Female Pelvic Medicine and Reconstructive Surgery | Obstetrics and Gynecology/Maternal-Fetal Medicine | Obstetrics and Gynecology/Urogynecology | UrologyForm of publication: Journal ArticleMedline article type(s): Case Reports | Journal ArticleSubject headings: *Replantation | *Ureter/su [Surgery] | *Ureteral Diseases/di [Diagnosis] | *Urinary Fistula/di [Diagnosis] | *Urologic Surgical Procedures/ae [Adverse Effects] | *Uterine Diseases/di [Diagnosis] | *Vesico-Ureteral Reflux/su [Surgery] | Adult | Female | Hematuria | Humans | Ureteral Diseases/et [Etiology] | Urinary Fistula/et [Etiology] | Uterine Diseases/et [Etiology]Year: 2015 ISSN:

2151-8378

Name of journal: Female pelvic medicine & reconstructive surgeryAbstract: Primary cyclic hematuria occurring with the onset of menstruation can be a presenting symptom of a fistula between the Mullerian structures (uterus/cervix/upper vagina) and the urinary tract. When occurring, these fistulas are most often vesicovaginal connections caused by congenital Mullerian anomalies. We present a case of a fistula occurring between a bicornuate uterus and the ureteral stump that had been ligated at the time of ureteral reimplantation during childhood. The presenting symptom was cyclic hematuria beginning at the age of 14 years with the onset of menarche. Cystoscopy and retrograde pyelogram showed a fistula connecting the ureteral stump (which had been ligated at the time of ureteral reimplantation) to the small horn of the bicornuate uterus. Computed tomographic scan showed bilateral single orthotopic kidneys and collecting systems. The patient underwent successful transvaginal and transvesical surgical repair of the fistula, with complete resolution of her cyclic hematuria. We review genitourinary embryology in discussion of this unusual case.All authors: Coviello E, Gutman RE, Loftus K, Richter LAFiscal year: FY2016Digital Object Identifier:

http://dx.doi.org/10.1097/SPV.0000000000000164

Date added to catalog: 2016-05-24

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Item type	Current library	Collection	Call number	Status	Date due	Barcode
Journal Article	MedStar Authors Catalog	Article	25730434	Available		25730434

Primary cyclic hematuria occurring with the onset of menstruation can be a presenting symptom of a fistula between the Mullerian structures (uterus/cervix/upper vagina) and the urinary tract. When occurring, these fistulas are most often vesicovaginal connections caused by congenital Mullerian anomalies. We present a case of a fistula occurring between a bicornuate uterus and the ureteral stump that had been ligated at the time of ureteral reimplantation during childhood. The presenting symptom was cyclic hematuria beginning at the age of 14 years with the onset of menarche. Cystoscopy and retrograde pyelogram showed a fistula connecting the ureteral stump (which had been ligated at the time of ureteral reimplantation) to the small horn of the bicornuate uterus. Computed tomographic scan showed bilateral single orthotopic kidneys and collecting systems. The patient underwent successful transvaginal and transvesical surgical repair of the fistula, with complete resolution of her cyclic hematuria. We review genitourinary embryology in discussion of this unusual case.

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