Endoscopic repair of a vesicouterine fistula with the injection of microfragmented autologous adipose tissue (Lipogems®).

Matteo Giulio Spinelli, Lorusso V, Palmisano F, Morelli M, Dell'Orto PG, Tremolada C, E. Montanari
Turkish journal of urology · 2020 · doi:10.5152/tud.2020.20170 · PMID:32744991 · PMC7483463
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A 35-year-old woman with a vesicouterine fistula was successfully treated using a minimally invasive endoscopic repair procedure involving the injection of microfragmented autologous adipose tissue.

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This case report describes the successful endoscopic repair of a vesicouterine fistula in a 35-year-old woman using microfragmented autologous adipose tissue. The authors note that vesicouterine fistulas are rare communications between the uterus and bladder, often resulting from iatrogenic injury during cesarean sections, which can lead to significant quality of life issues and infertility. While surgical intervention is typically required due to the low success rates of conservative approaches, this minimally invasive technique demonstrated efficacy in resolving the pathology without major complications. This paper is centrally about adenomyosis and endometriosis only insofar as it addresses a uterine pathology; however, the specific condition treated is a vesicouterine fistula, not endometriosis or adenomyosis, and the paper does not explicitly discuss those conditions.

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Abstract

Vesicouterine fistula (VUF) is a rare extra-anatomical communication developing between the uterus or cervix and the urinary bladder, most commonly after an iatrogenic injury during a cesarean section. Patients with VUF may have various clinical presentations, ranging from Youssef's syndrome (vaginal urine leakage, amenorrhea, and menouria) to urinary tract infection and infertility. Quality of life for patients having this pathology is strongly affected owing to the psychological burden. Treatment is surgery based because low success rates have been reported for conservative or minimally invasive approaches. Herein, we present a case of a 35-year-old woman successfully treated by a minimally invasive endoscopic repair procedure with the injection of microfragmented autologous adipose tissue (Lipogems®).
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Abstract Vesicouterine fistula (VUF) is a rare extra-anatomical communication developing between the uterus or cervix and the urinary bladder, most commonly after an iatrogenic injury during a cesarean section. Patients with VUF may have various clinical presentations, ranging from Youssef’s syndrome (vaginal urine leakage, amenorrhea, and menouria) to urinary tract infection and infertility. Quality of life for patients having this pathology is strongly affected owing to the psychological burden. Treatment is surgery based because low success rates have been reported for conservative or minimally invasive approaches. Herein, we present a case of a 35-year-old woman successfully treated by a minimally invasive endoscopic repair procedure with the injection of microfragmented autologous adipose tissue (Lipogems®). Cite this article as: Spinelli M.G, Lorusso V, Palmisano F, Morelli M, Dell’Orto PG, Tremolada C, et al. Endoscopic repair of a vesicouterine fistula with the injection of microfragmented autologous adipose tissue (Lipogems®). Turk J Urol 2020; 46(5): 398-402.

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