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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

Madueke-Laveaux, Obianuju Sandra MD, MPH; Platte, Raisa MD, PhD; Poplawsky, Deborah MD

Female Pelvic Medicine & Reconstructive Surgery: September/October 2013 - Volume 19 - Issue 5 - p 306–308
doi: 10.1097/SPV.0b013e3182996cee
Case Reports

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.

A vesicocervical fistula was diagnosed on cystoscopic examination after removal, from the cervix, of Mersiline tape from a Shirodkar cerclage placed 13 years earlier for management of cervical insufficiency.

From the Department of Obstetrics and Gynecology, Geisinger Medical Center, Danville, PA.

Reprints: Obianuju Sandra Madueke-Laveaux, MD, MPH, Department of Obstetrics and Gynecology, Geisinger Medical Center, 100 N Academy Dr, Danville, PA 17822. E-mail: somadueke@gmail.com.

The authors have declared they have no conflicts of interest.

© 2013 by Lippincott Williams & Wilkins