Uterocutaneous fistula: A rare complication of cesarean section

A uterocutaneous fistula is an abnormal tract between the endometrium of the uterus and the skin. It is a rare but significant postcesarean section complication. This is a case of a 39-year-old female who presented with cyclical bleeding from her cesarean section scar during menstruation over the past 4 years. The assessment revealed a discharging sinus in the scar and an acutely anteverted, fixed uterus. Symptoms persisted despite medical treatment for the provisional diagnosis of endometriosis. The diagnosis was updated as uterocutaneous fistula based on a computed tomography scan of the pelvis and abdomen and a hysterosalpingogram. The fistula was surgically excised, and a hysterectomy was performed. This report elaborates on the rare presentation, diagnosis, and definitive surgical management. The surgical management resulted in a successful resolution, highlighting the importance of choosing the appropriate treatment modality while adhering to a patient-centered approach.

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Publication Details

Journal
Philippine Journal of Obstetrics and Gynecology
Published
2025-01-01
DOI
https://doi.org/10.4103/pjog.pjog_60_24
Primary Topic
Ureteral procedures and complications
Type
article
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article

Uterocutaneous fistula: A rare complication of cesarean section

Ashani Ratnayake, Sampath Gnanarathne, Ayodhya Kariyawasam
Philippine Journal of Obstetrics and Gynecology
Ureteral procedures and complications
article

Uterocutaneous fistula: A rare complication of cesarean section

Ashani Ratnayake, Sampath Gnanarathne, Ayodhya Kariyawasam
article en

Abstract

A uterocutaneous fistula is an abnormal tract between the endometrium of the uterus and the skin. It is a rare but significant postcesarean section complication. This is a case of a 39-year-old female who presented with cyclical bleeding from her cesarean section scar during menstruation over the past 4 years. The assessment revealed a discharging sinus in the scar and an acutely anteverted, fixed uterus. Symptoms persisted despite medical treatment for the provisional diagnosis of endometriosis. The diagnosis was updated as uterocutaneous fistula based on a computed tomography scan of the pelvis and abdomen and a hysterosalpingogram. The fistula was surgically excised, and a hysterectomy was performed. This report elaborates on the rare presentation, diagnosis, and definitive surgical management. The surgical management resulted in a successful resolution, highlighting the importance of choosing the appropriate treatment modality while adhering to a patient-centered approach.

Philippine Journal of Obstetrics and GynecologyVol. 49(1)
University of Peradeniya (LK)
Openalex Percentile: Top 92%
Ureteral procedures and complications
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Uterocutaneous fistula: A rare complication of cesarean section — Ashani Ratnayake, Sampath Gnanarathne, et al. · Philippine Journal of Obstetrics and Gynecology (2025) | TGRS Research Map | TGRS