Cystoscopic fistulography: A new technique for the diagnosis of vesicocervical fistula

BACKGROUND: Most fistulas communicating with the bladder are large enough to be diagnosed easily, or small enough to dose spontaneously without clinical sequel. A vesicocervical fistula is an uncommon event and may be difficult to diagnose. TECHNIQUE: During an operative cystourethroscopy procedure, suspicious areas of the bladder can be probed with a cone tip catheter and injected with contrast dye to visualize the suspected fistula communicating with the bladder. EXPERIENCE: This technique was employed when a double dye test, an intravenous urogram, a cystogram, a computed tomography scan, and a hysterogram failed to localize the fistulous tract in a patient who was 3 weeks postpartum after a repeat cesarean with complaint of persistent urinary incontinence. CONCLUSION: Cystoscopic catherization of suspicious lesions in the bladder may visualize an otherwise elusive fistulous tract. (Obstet Gynecol 2001;98:1124-6. (C) 2001 by the American College of Obstetricians and Gynecologists.).