Korean J Obstet Gynecol.  2012 Feb;55(2):132-136. 10.5468/KJOG.2012.55.2.132.

A case of rectovesical fistula after laparoscopy assisted vaginal hysterectomy

• Lee JY
• Lee HA
• Na SH
• Hwang JY
• Lee DH

• KMID: 2078128
• DOI: http://doi.org/10.5468/KJOG.2012.55.2.132

Abstract

Vesicovaginal fistulas are a most common complication accompanied by gynecologic surgeries, but other types of fistulas rarely occur. Especially rectovesical fistulas arising post-operative complication occur in extremely lower possibility and very few cases have been reported in the world. Interestingly, our case showed a symptom of urinary drainage from the anus unlike other cases with pneumaturia or fecaluria. This symptom could hardly happen because urine is prevented from being released due to the internal pressure of the fistula. We experienced and treated a first case of rectovesical fistula with a symptom of passing urine from the anus.

Keyword

Rectovesical fistula; Hysterectomy; Rectal perforation

MeSH Terms

Anal Canal
Drainage
Female
Fistula
Gynecologic Surgical Procedures
Hysterectomy
Hysterectomy, Vaginal
Laparoscopy
Vesicovaginal Fistula

Figure

• 

  Fig. 1 Cystography shows drainage of contrast medium in the bladder (arrow) into the proximal rectum (open arrow). (A) Immediately after injection of contrast medium into the bladder. (B) Two minutes after injection.

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  Fig. 2 Contrast enhanced computerized tomography of pelvis demonstrates contrast material in rectovesical fistula located from the posterior vesical wall (arrow) to the recto-sigmoid junction (open arrow). This scan was performed immediately after the cystography.

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  Fig. 3 Contrast enhanced computerized tomography of pelvis demonstrates that the rectovesical fistula no longer exists and there is no evidence of complicated fluid collection in the pelvic cavity. This scan was performed 2 weeks after the operation.

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