Uterine Perforation Complicating Vesico-Vaginal Fistula Repair: A Case Report

Case Report

Abstract

Obstetric fistula is a problem among women in developing countries. The patient presented with intra-cervical fistula following Caesarean section for prolonged obstructed labour. The fistula was repaired vaginally. She developed features of intra-peritoneal haemorrhage after repair and had exploratory laparotomy which revealed a perforated uterus. She had uterine repair and was later discharged continent. Uterine perforation is not a known complication of vesico-vaginal fistula repair. It may have resulted from sounding of the uterus and introduction of intrauterine catheter using a metal introducer. Subsequent inflation of the balloon with fluid may have increased the uterine injury. Preparation for blood transfusion should be an important part of management of women with intra-cervical fistula.