BACKGROUND: Impedance-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.
Vesico-uterine fistulae can occur after impedance-controlled endometrial ablation in women with multiple prior low transverse cesarean deliveries.
From the Women's Continence Center of Greater Rochester, Rochester, New York.
Corresponding author: Kristin E. Rooney, MD, 500 Helendale Road, Suite 265, Rochester, NY 14609; e-mail: firstname.lastname@example.org.
Financial Disclosure Dr. Cholhan has been a consultant and trainer for Boston Scientific Corporation (Washington, DC). The other author did not report any potential conflicts of interest.