CT of Vesicocorporeal Fistula with Menouria

CT of Vesicocorporeal Fistula with Menouria A Complication of Uterine Biopsy - Virginia P. Mercader - James F. McGuckin - Dina F. Caroline - Ashwin Chatwani - E. James Seidmon Vesicouterine fistulas are a rare complication of obstetrical-gynecological interventions and are the least common of the acquired urogenital fistulas. They are almost solely associated with cesarean section. A case is reported in which a patient with adenomyosis and pelvic adhesions presented with menouria (vesical menstruation) after uterine biopsy. A vesicocorporeal fistula was demonstrated by cystography and CT and confirmed by cystoscopy and hysteroscopy. Index Terms Fistula and fistulas—Biopsy and biopsies—Surgery, complications—Menouria—Computed tomography. SUMMARY Vesicouterine fistulas are rare. Their incidence has increased over the last 40 years and are associated with the use of low-segment cesarean sections. Other predisposing factors for the development of vesicouterine fistulas include uterovesical adhesions and underlying uterine fragility. This case demonstrates a vesicouterine fistula presenting after an endometrial biopsy in a patient with underlying adenomyosis and uteropelvic adhesions. As radiologists, we have many options to diagnose vesicouterine fistulas. We present an alternate method of identifying the abnormal communication via CT in addition to the more commonly utilized modalities of urography, cystography, and hysterography.