Vesicouterine fistula--a review.

Ninety-two cases of vesicouterine fistula reported in the world literature since 1908 are reviewed. The lesion was rarely seen before 1947. It usually followed a vaginal operative delivery and the usual complaint was total urinary incontinence. Diagnosis was most often made indirectly by seeing urine or dye pass through an intact external cervical os. Management usually involved a vaginal, surgical approach to repair. Since 1947, vesicouterine fistula, while not common, is no longer rare. It occurs most often after low segment cesarean section. While urinary incontinence may occur, the major symptom is cyclic hematuria (menouria). The diagnosis is best made by hysterogram performed with a short-tipped cannula. Management consists of an abdominal, surgical approach, the technique of which varies with the patient's need for future reproductive capacity.