Vesico-Uterine Fistula After Endometrial Ablation in a Woman With Prior Cesarean Deliveries

BACKGROUND: Impeclance-controlled endometrial ablation is a common procedure for menorrhagia in premenopausal women with relatively few contraindications. CASE: 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. CONCLUSION: Vesico-uterine fistula may be associated with impedance-controlled endometrial ablation in women with prior low transverse cesarean deliveries. (Obstet Gynecol 2010,115:450-1)