Vesical ectopic pregnancy due to vesicouterine fistula: A case report with literature review

Int J Gynaecol Obstet. 2024 Jun;165(3):889-893. doi: 10.1002/ijgo.15258. Epub 2023 Nov 21.

Abstract

This case report describes the presentation, diagnosis, and surgical management of a rare vesical ectopic pregnancy in a 36-year-old woman with a history of multiple cesarean sections. The patient presented with symptoms of suprapubic pain, fever, and amenorrhea. An initial ultrasound indicated retained products of conception, leading to a preliminary diagnosis of septic miscarriage. However, subsequent rescanning revealed an empty uterus and a non-viable fetus within the bladder, connected to the uterine cavity. Cystoscopy confirmed the presence of fetal parts inside the bladder. Finally, a laparotomy was performed and the fetus was removed from the bladder with repair of the underlying uterovesical fistula. An uneventful postoperative period ensued. The literature review revealed only four previously reported cases with similar overall presentations. This case highlights the importance of considering vesical ectopic pregnancies in patients with a history of cesarean sections and unusual symptoms, as prompt surgical intervention is crucial for ensuring successful management of the condition.

Keywords: bladder; ectopic pregnancy; fetus; fistula; septic miscarriage.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Adult
  • Cesarean Section*
  • Cystoscopy
  • Female
  • Fistula / diagnosis
  • Fistula / surgery
  • Humans
  • Pregnancy
  • Pregnancy, Ectopic* / diagnosis
  • Pregnancy, Ectopic* / surgery
  • Urinary Bladder Fistula* / diagnosis
  • Urinary Bladder Fistula* / etiology
  • Urinary Bladder Fistula* / surgery
  • Uterine Diseases* / complications
  • Uterine Diseases* / diagnosis
  • Uterine Diseases* / surgery