Uterocutaneous Fistula Following Cesarean Section: Successful Management of a Case

Document Type: Case Report(s)

Authors

1 Endoscopic and Minimally Invasive Surgery Research Center, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran

2 Student Research Committee, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran

3 Solid Tumor Treatment Research Center, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran

Abstract

A uterocutaneous fistula is a rare clinical presentation that occurs following Cesarean section and other pelvic operations. There are only a few reports discussing the treatments. We describe a patient with successful surgical management and review the literature. A 25-year-old woman referred to our department 13 months after her first Cesarean section. She had a history of an abdominal mass and collection 2 months after surgery and some fistula opening with discharge from her previous incision. She had a previous surgical operation and antibiotic therapy without complete response. We performed fistulography to evaluate the tracts. In the operation — she had fistula tracts, one of which was between the uterus and skin. We debrided the necrotic tissue in the uterus, excised the fistula tracts, and drained the uterine cavity. At 8 months’ postoperative follow-up, she had no recurrence. A uterocutaneous fistula is a rare condition with many causes and needs proper investigation and timely medical and surgical management.

Keywords


  1. Gupta SK, Shukla VK, Varma DN, Roy SK. Uterocutaneous fistula. Postgrad Med J. 1993;69:822-3. doi: 10.1136/pgmj.69.816.822. PubMed PMID: 8290420; PubMed Central PMCID: PMC2399982.
  2. Eldem G, Turkbey B, Balas S, Akpinar E. MDCT diagnosis of uterocutaneous fistula. European Journal of Radiology Extra. 2008;67:e129-e30. doi: 10.1016/j.ejrex.2008.05.009.
  3. Thubert T, Denoiseux C, Faivre E, Naveau A, Trichot C, Deffieux X. Combined conservative surgical and medical treatment of a uterocutaneous fistula. J Minim Invasive Gynecol. 2012;19:244-7. doi: 10.1016/j.jmig.2011.10.010. PubMed PMID: 22381970.
  4. Dragoumis K, Mikos T, Zafrakas M, Assimakopoulos E, Stamatopoulos P, Bontis J. Endometriotic uterocutaneous fistula after cesarean section. A case report. Gynecol Obstet Invest. 2004;57:90-2. doi: 10.1159/000075384. PubMed PMID: 14671417.
  5. Sonmezer M, Sahincioglu O, Cetinkaya E, Yazici F. Uterocutaneous fistula after surgical treatment of an incomplete abortion: methylene blue test to verify the diagnosis. Arch Gynecol Obstet. 2009;279:225-7. doi: 10.1007/s00404-008-0683-7. PubMed PMID: 18506462.
  6. Promsonthi P, Herabutya Y. Uterocutaneous fistula in term abdominal pregnancy. Eur J Obstet Gynecol Reprod Biol. 2007;132:239‑41. doi: 10.1016/j.ejogrb.2006.04.041. PubMed PMID: 16806645.
  7. Shukla D, Pandey S, Pandey LK, Shukla VK. Repair of uterocutaneous fistula. Obstet Gynecol. 2006;108:732-3. doi: 10.1097/01.AOG.0000188067.74163.40. PubMed PMID: 17018482.
  8. Tedeschi A, Di Mezza G, D’Amico O, Ermann A, Montone L, Siciliano M, et al. A case of pelvic actinomycosis presenting as cutaneous fistula. Eur J Obstet Gynecol Reprod Biol. 2003;108:103-5. doi: 10.1016/S0301-2115(02)00361-5. PubMed PMID: 12694981.
  9. Ruiz Arteaga JD, Valdez Murillo AN, Hernandez Trejo MC. Utero-cutaneous fistula: a case report and literature review. Ginecol Obstet Mex. 2012;80:95-8. PubMed PMID: 22519218.
  10. Okoro O, Onwere S. Retained products of conception in a utero cutaneous fistula: a case report. Niger J Clin Pract. 2008;11:170‑1. PubMed PMID: 18817061.
  11. Seyhan A, Ata B, Sidal B, Urman B. Medical treatment of uterocutaneous fistula with gonadotropin-releasing hormone agonist administration. Obstet Gynecol. 2008;111:526-8. doi: 10.1097/01.AOG.0000281670.94265.5c. PubMed PMID: 18239009.