Monti's Principle in the Treatment of Congenital Uterovesical Fistula

Congenital uterovesical fistula is rare and generally associated with genital tract abnormalities derived from mullerian ducts or urogenital sinus. Management is usually challenging, and it involves vaginal reconstruction. A 15-year-old female patient presented with a 2-year history of cyclical hema...

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Bibliographic Details
Published in:Urology (Ridgewood, N.J.) N.J.), 2014-05, Vol.83 (5), p.1170-1172
Main Authors: Lopes, Roberto Iglesias, Dénes, Francisco Tibor, Padovani, Guilherme, Sircili, Maria Helena, Srougi, Miguel
Format: Article
Language:English
Subjects:
Adolescent
Biological and medical sciences
Female
Fistula - congenital
Fistula - surgery
Gynecologic Surgical Procedures - methods
Humans
Medical sciences
Nephrology. Urinary tract diseases
Urinary Bladder Fistula - congenital
Urinary Bladder Fistula - surgery
Urologic Surgical Procedures - methods
Urology
Uterine Diseases - congenital
Uterine Diseases - surgery
Vagina - surgery
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Summary:Congenital uterovesical fistula is rare and generally associated with genital tract abnormalities derived from mullerian ducts or urogenital sinus. Management is usually challenging, and it involves vaginal reconstruction. A 15-year-old female patient presented with a 2-year history of cyclical hematuria. Investigation revealed a bicornuate uterus and complete vaginal agenesis associated with congenital uterovesical fistula. The fistula was repaired, and a neovagina was created using Monti's technique. Postoperative recovery was uneventful with normal voiding and initiation of regular menstruation through the neovagina. We discuss the options of vaginal reconstruction and stress the advantages of the technique used in this case.
ISSN:0090-4295
1527-9995
DOI:10.1016/j.urology.2013.12.040