Obstet Gynecol Sci.  2018 Sep;61(5):641-644. 10.5468/ogs.2018.61.5.641.

Uterocutaneous fistula after pelviscopic myomectomy - successful diagnosis with hystero-salpingo contrast sonography and complete tract resection and medical treatment for fertility preservation in young woman: a case report

• Min KJ
• Lee J
• Lee S
• Lee S
• Hong JH
• Song JY
• Lee JK
• Lee NW

• KMID: 2426032
• DOI: http://doi.org/10.5468/ogs.2018.61.5.641

Abstract

A uterocutaneous fistula is rarely reported clinical condition after uterine procedures. Many diagnostic and management strategies are being suggested. In this case report, uterocutaneous fistula after pelviscopic myomectomy was diagnosed simply with hystero-salpingo contrast sonography and managed by surgical tract excision without hysterectomy and uterine wall dehiscence repair combined with medical treatment using gonadotropin-releasing hormone agonist succeeded to preserve fertility in young woman.

Keyword

Cutaneous fistula; Fertility preservation; Treatment

MeSH Terms

Cutaneous Fistula
Diagnosis*
Female
Fertility Preservation*
Fertility*
Fistula*
Gonadotropin-Releasing Hormone
Humans
Hysterectomy
Gonadotropin-Releasing Hormone

Figure

• 

  Fig. 1 (A) Hysterosalpingo contrast sonography. Each marks mean follow as; Astrix - uterine outline, short arrow - EM cavity with catheter ballooning, long arrow - contrast leakage through right side of fundus to the pelvic cavity, and B - bowel. (B) postoperative sono revealing well margined myometrium.

• 

  Fig. 2 Postoperative abdominal-pelvic computed tomography; immediate postoperative state without evidence of dehiscence. Arrow means sutured uterine wall.

Reference

1. Pratibha S, Rajni B. Uterocutaneous fistula following septic abortion: can it heal without major surgical intervention? J Obstet Gynaecol. 2015; 35:651–652.

2. Maddah G, Fattahi AS, Rahnama A, Jamshidi ST. Uterocutaneous fistula following cesarean section: successful management of a case. Iran J Med Sci. 2016; 41:157–160.

3. Athanasias P, Krishna A, Karoshi M, Moore J, Chandraharan E. Uterocutaneous fistula following classical caesarean delivery for placenta percreta with intentional retention of the placenta. J Obstet Gynaecol. 2013; 33:906–907.

4. Sönmezer M, Sahincioğlu 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; 279:225–227.

5. Case TC. Uterocutaneous fistula; a case report. Obstet Gynecol. 1958; 12:233–234.

6. Gupta SK, Shukla VK, Varma DN, Roy SK. Uterocutaneous fistula. Postgrad Med J. 1993; 69:822–823.

7. 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; 57:90–92.

8. Promsonthi P, Herabutya Y. Uterocutaneous fistula in term abdominal pregnancy. Eur J Obstet Gynecol Reprod Biol. 2007; 132:239–241.

9. Seyhan A, Ata B, Sidal B, Urman B. Medical treatment of uterocutaneous fistula with gonadotropin-releasing hormone agonist administration. Obstet Gynecol. 2008; 111:526–528.

10. 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; 19:244–247.

11. Yadav P, Gupta S, Singh P, Tripathi S. Successful medical management of uterocutaneous fistula. Int J Gynaecol Obstet. 2014; 124:263–264.