Vesico-peritoneal fistulae after ceasarean section: Insights from three case studies

Vesico-peritoneal fistula represents an abnormal path between the abdominal cavity and the bladder.In this study, we present three clinical cases of vesico-peritoneal fistula that developed after cesarean section, each exhibiting symptoms of pain and abdominal distension.The first case involved a bladder injury that was identified intraoperatively during the C-section and was promptly repaired.The remaining two cases were associated with thermal injuries inflicted by electrocautery during the surgical procedure.In all three patients, laboratory analyses revealed that urea and creatinine levels remained within normal limits.Diagnostic approaches varied: Two cases were diagnosed through transabdominal ultrasound-guided needle aspiration of ascitic fluid, while the third case was confirmed via cystogram.Therapeutic intervention for all cases involved cystoscopy, surgical excision of the fistula tract, excision of the bladder fistula, and subsequent multilayered bladder repair utilizing an omental flap.Postoperative management included a 10-day period of bladder drainage, after which all patients demonstrated uneventful recoveries.These findings underscore the importance of recognizing vesico-peritoneal fistula as a potential complication of C-section, particularly in the context of intraoperative bladder injury or electrocautery use.