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Neurourol Urodyn. 2018 Nov;37(8):2361-2367. doi: 10.1002/nau.23795. Epub 2018 Aug 14.

Congenital vesicouterine fistulas-A PRISMA-compliant systematic review.

Author information

1
Department of Gynecology and Gynecologic Oncology, Medical University of Białystok, Białystok, Poland.
2
Department of Gynecology and Obstetrics, Faculty of Medicine, University of Warmia and Mazury, Olsztyn, Poland.
3
IIND Department of Gynecology, Medical University of Lublin, Lublin, Poland.
4
Department of Biophysics, Medical University of Białystok, Białystok, Poland.
5
Chair of Clinical Sciences, Faculty of Health Sciences, State Higher School of Computer Science and Business Administration, Łomża, Poland.
6
Department of Reproductive Health, National Research Institute of Mother and Child, Warsaw, Poland.

Abstract

AIMS:

Vesicouterine fistulas (VUFs) are infrequent abnormal connections between the bladder and the uterine cavity or cervical canal, being mainly sequelae of repeat Cesarean sections. Exceedingly rare are congenital VUFs. This is a systematic review of available world data aimed to characterize congenital VUFs and better understand the mechanism(s) of their formation.

METHODS:

The PubMed® database via MEDLINE® search engine was explored from its inception to March 2018. Relevant studies were identified using selected Medical Subject Heading-based terms. This was further supplemented by cross-referencing and handsearching. Retrieved literature was evaluated in line with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses, or PRISMA, guidelines.

RESULTS:

A total of 6561 articles were identified of which 10 were analyzed. Three VUFs accompanied broader syndromes of congenital defects. A lack of patency at the level of the vagina was present in all assessed cases. Unilateral renal agenesis was confirmed in four of eight (50%) verified patients. Hence, unilateral kidney agenesis was related to a lesser degree (P = 0.0186) than vaginal atresia to VUF. The principal features of these fistulas were as follows: partial or complete vaginal atresia resulting in primary amenorrhea, menouria present since menarche, and urinary continence.

CONCLUSIONS:

This review provides the first systematic evidence that congenital VUFs are chiefly associated with concomitant vaginal atresia. The symptomatology of such VUFs is consistent with that of type I acquired fistulas.

KEYWORDS:

congenital abnormalities; urinary bladder fistula; uterus; women (MeSH browser based)

PMID:
30106189
DOI:
10.1002/nau.23795

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