science

Vesicouterine fistula

Vesicouterine fistula is a science topic covered in the lgStudy science library. This page brings together a partial reference excerpt, illustrations, worked examples, real-world applications and a short study plan, so you can understand Vesicouterine fistula rather than just read about it. In short: Vesicouterine fistula refers to an abnormal communication between the bladder and uterus. The first case of vesicouterine fistula was reported in 1908.

Key takeaways

Vesicouterine fistula belongs to science; place it in that map before memorising details.
Learn the definition first, then one example that makes the definition concrete.
Connect Vesicouterine fistula to a quantity you can measure, compute or draw — that is where exam questions come from.
Reproduce the core statement of Vesicouterine fistula from memory before moving on to harder problems.

Reference excerpt

Vesicouterine fistula refers to an abnormal communication between the bladder and uterus. The first case of vesicouterine fistula was reported in 1908. It was however first described in 1957 by Abdel Fattah Youssef, an obstetrician and gynaecologist in Kasr el-Aini hospital, Cairo, Egypt. It is characterized by a vesicouterine fistula above the level of the internal os, absence of menstrual bleeding, cyclical presence of blood in urine and absence of urinary incontinence with a patent cervical canal following a lower segment caesarean section. Six of such cases had been reported by other clinicians before the term Menouria was coined by Youssef.

Pathology Vesicouterine fistula is the least common type of urogenital fistula accounting for 1-4% of urogenital fistulas. It occurs following lower segment caesarean section and the incidence is increasing due to the increasing incidence of caesarean deliveries. The occurrence of menoruria in the absence of vaginal bleeding or passage of urine from the vagina is attributed to a sphincteric mechanism of the uterine isthmus. Jozwik and Jozwik classified vesicouterine fistula into three types based on the route of menstrual flow;

I - Menstrual flow from the bladder only without urinary incontinence II - Menstrual flow from both the bladder and vagina with urinary incontinence III - Normal menstrual flow from the vagina only (no menouria) with urinary incontinence Youssef syndrome corresponds to a type I vesicouterine fistula.

Causes Vesicouterine fistulas occur most commonly after lower segment caesarean sections (about 83-93% of cases). The possible mechanisms by which vesicouterine fistulas occur following caesarean sections include undetected bladder injury during caesarean section, inadvertent placement of a suture through the bladder during the repair of the uterus and abnormal blood vessel connections following multiple caesarean sections. It may also present following use of obstetric forceps, manual placenta removal, external cephalic version, morbidly adherent placenta, surgical removal of fibroids, rupture of the uterus, perforation of the uterus and radiation therapy in the treatment of cervical cancer. Vesicouterine fistula can also occur as a birth defect in conjunction with vaginal atresia.

Diagnosis The diagnosis of a vesicouterine fistula is made by demonstrating an abnormal connection between the cavities of the bladder and uterus. It can be diagnosed using hysterosalpingography, hysterography, cystography, magnetic resonance imaging (MRI) and computerised tomography. MRI has been found to have 100% accuracy in the diagnosis of vesicouterine fistula. It is also less invasive than other modalities and is considered the gold standard for diagnosis.

Treatment The options of treatment include watchful waiting for spontaneous resolution of the fistula, use of medications that can stop menstrual periods such as oral contraceptive pills, progesterone and gonadotropin releasing hormone analogs. Surgery can be carried out through the vagina, bladder or peritoneum and can be done via laparoscopic or robotic surgery. Watchful waiting is the treatment of choice in case of small fistulas. The bladder is catheterised for a period of 4 to 8 weeks in order to allow spontaneous closure of the vesicouterine fistula. Fulguration of the fistula can also be done via cystoscopy in cases of small fistulas.

Differential diagnosis Endometriosis

Illustrations

Worked examples

Example 1 — a first encounter with Vesicouterine fistula

Start with the simplest possible case. Write down what Vesicouterine fistula claims or describes in one sentence, then invent the smallest concrete situation in which that sentence is true. In science, the smallest case is usually a single object, a single equation or a single measurement. Check that every symbol or term in your sentence has a meaning in that case.

Example 2 — changing one variable

Take the situation from Example 1 and change exactly one quantity: double it, halve it, or set it to zero. Predict what should happen to Vesicouterine fistula before you calculate. Comparing your prediction with the result is the fastest way to find out whether you understand the idea or only the words.

Example 3 — an exam-style question

Typical questions about Vesicouterine fistula ask you to (a) state it precisely, (b) apply it to given data, and (c) explain a limitation. Practise writing all three answers in under five minutes; the third part is what separates a full-mark answer from an average one.

Applications of Vesicouterine fistula

In research: Vesicouterine fistula appears in science research whenever the underlying quantities have to be modelled precisely. Papers usually cite it as a starting assumption and then explore where it breaks down.
In technology and industry: Engineering practice reuses Vesicouterine fistula in design rules, simulations and safety margins. Knowing the idea lets you read a specification sheet and understand why the numbers look the way they do.
In the classroom: Vesicouterine fistula is common in secondary-school and first-year university syllabi. It links to neighbouring topics Fistulas, so understanding it makes those chapters shorter.
In everyday life: Look for Vesicouterine fistula outside the textbook — in sport, cooking, traffic, electronics or the sky above you. An example you found yourself is remembered far longer than one you were given.

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How to study Vesicouterine fistula in 20 minutes

Read the reference excerpt below once, without taking notes.
Close the page and write down what Vesicouterine fistula means in your own words.
Compare your version with the excerpt and mark what you missed.
Work through the three examples above with pen and paper.
Explain Vesicouterine fistula out loud to somebody else — or to Teacher Smith in the lgStudy chat.

Frequently asked questions

What is Vesicouterine fistula in simple terms?

Vesicouterine fistula refers to an abnormal communication between the bladder and uterus. The first case of vesicouterine fistula was reported in 1908.

Why does Vesicouterine fistula matter?

Because it connects several science ideas at once: it gives you a definition you can apply, a quantity you can calculate, and a way to check whether a result is plausible.

How should I study Vesicouterine fistula?

Read the excerpt, restate it from memory, then work through the examples and applications listed on this page. The five-step study plan above takes about twenty minutes.

What does this page cover?

It gives you a compact reference excerpt plus original lgStudy explanations, examples, applications and study material on Vesicouterine fistula.