Diagnosis and management of uterocutaneous fistula following cesarean section: A case report.

Uterocutaneous fistula following cesarean delivery is an exceptionally rare complication, defined by an abnormal tract between the uterine cavity and the abdominal scar. We report a 28-year-old woman who presented three months and half after a cesarean section with cyclical bloody discharge from a Pfannenstiel scar, preceded by a superficial wound infection. Pelvic magnetic resonance imaging (MRI) precisely delineated the tract, revealing a 21 mm anterior uterine wall defect communicating with a 25 mm subcutaneous collection, and informed surgical planning. Management included complete fistulectomy with layered uterine repair, followed by a three month course of a gonadotropin-releasing hormone (GnRH) analogue. Postoperative recovery was uneventful, with no recurrence during follow-up. This case highlights an infection-associated delayed presentation and illustrates the value of quantitative MRI mapping combined with short-course hormonal suppression to achieve durable closure while preserving fertility. (Afr J Reprod Health 2026; 30 [8]: 140-146).