Postmyomectomy Uterocutaneous Fistula

Abstract

Abstract

Background: Uterocutaneous fistula, although not exceptional, is a very rare clinical entity. Approximately 120 cases of uterocutaneous fistula have been reported in the world literature in its entirety over the past 200 years. It occurs most often after uterine or pelvic surgery but also can complicate the postpartum period. This article reports the first documented case of postmyomectomy uterocutaneous fistula observed in this department. Case: The patient, a 30-year-old black African woman, primigravida and nulliparous, had a history of a difficult myomectomy performed June 9, 2011 by a general surgeon. She consulted the authors' department on November 4, 2011, 5 months after myomectomy for bleeding at the surgical scar. The bleeding had been present for 5 months cyclically and at the same time period as her menstruations. Physical examination and the results of exploration revealed an uterocutaneous fistula. At laparotomy, the fistula was excised followed by a uterine suture. Results: The postoperative course was uneventful with resumption of menses vaginally. Conclusions: Although medical and surgical conservative treatment is mostly successful, the best treatment of uterocutaneous fistula remains prevention based on better uterine surgery technique, prevention of postoperative infection, and good control of certain obstetric procedures. (J GYNECOL SURG 29:36)