Unique complication of a Shirodkar cerclage: remote formation of a vesicocervical fistula in a patient with the history of cervical cerclage placement: a case report and literature review.

BACKGROUND: Cervical cerclage placement is an accepted treatment for cervical insufficiency and recurrent second-trimester pregnancy loss. The most commonly described complications of cerclage include rupture of fetal membranes, intra-amniotic infection, endometritis, and peripartum bleeding. We present a unique case of a vesicocervical fistula formation remote from cerclage placement.

CASE: A vesicocervical fistula was diagnosed in a 51-year-old patient who presented with a chief complaint of vaginal bleeding. The fistula was found on cystoscopic examination after the extrusion, from the cervix, of Mersilene tape from a Shirodkar cerclage placed 13 years earlier for management of cervical insufficiency.

CONCLUSION: Although the presented condition was managed conservatively, one should discuss remote formation of urogenital fistulae as a rare complication of cervical cerclage at the time of informed consent.