Vesico-uterine fistula after endometrial ablation in a woman with prior cesarean deliveries.

Abstract

Impedance-controlled endometrial ablation is a common procedure for menorrhagia in premenopausal women with relatively few contraindications. A 54-year-old woman with an obstetric history significant for three prior low transverse cesarean deliveries reported a constant drip of urine from the vagina beginning approximately 2 weeks after impedance-controlled endometrial ablation for menorrhagia. Evaluation confirmed a vesico-uterine fistula in the area of the prior cesarean delivery scars. The patient underwent a successful repair of the fistula using the abdominal approach. Vesico-uterine fistula may be associated with impedance-controlled endometrial ablation in women with prior low transverse cesarean deliveries.