{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,14]],"date-time":"2026-04-14T06:30:22Z","timestamp":1776148222999,"version":"3.50.1"},"reference-count":17,"publisher":"BMJ","issue":"8","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2021,7,19]]},"published-print":{"date-parts":[[2021,8]]},"abstract":"<jats:p>Vesicouterine fistula is one of the rare varieties of urogenital fistula. Type I urogenital fistula or Youssef syndrome is characterised by menouria, amenorrhoea and urinary continence and it mostly follows lower segment caesarean delivery. There are only scattered case reports to help guide diagnostic and therapeutic options for this condition. These patients mostly need a combination of diagnostic modalities to confirm the diagnosis. Here, we present one such case of para 4 live 4 with classical symptoms of Youssef syndrome following a laparotomy for uterine rupture repair. CT urography confirmed the diagnosis and cystoscopy helped localise the exact location. Transabdominal fistula excision and repair was done. The paper also presents a summary of diagnostic and therapeutic options for this condition as reported in previous case reports for easy reference for practising gynaecologists and urologists.<\/jats:p>","DOI":"10.1136\/bcr-2021-244247","type":"journal-article","created":{"date-parts":[[2021,8,10]],"date-time":"2021-08-10T13:21:38Z","timestamp":1628601698000},"page":"e244247","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":5,"title":["Youssef syndrome with a summary of management options"],"prefix":"10.1136","volume":"14","author":[{"given":"Anupama","family":"Bahadur","sequence":"first","affiliation":[{"name":"Obstetrics and Gynaecology, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8566-1961","authenticated-orcid":false,"given":"Anoosha K","family":"Ravi","sequence":"additional","affiliation":[{"name":"Obstetrics and Gynaecology, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Megha","family":"Ajmani","sequence":"additional","affiliation":[{"name":"Obstetrics and Gynaecology, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3359-2239","authenticated-orcid":false,"given":"Rajlaxmi","family":"Mundhra","sequence":"additional","affiliation":[{"name":"Obstetrics and Gynaecology, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2021,8,10]]},"reference":[{"key":"2025082801481792000_14.8.e244247.1","doi-asserted-by":"publisher","DOI":"10.1016\/0002-9378(57)90384-8"},{"key":"2025082801481792000_14.8.e244247.2","doi-asserted-by":"crossref","first-page":"353","DOI":"10.1016\/S0020-7292(00)00247-2","article-title":"Clinical classification of vesicouterine fistula","volume":"70","author":"J\u00f3zwik","year":"2000","journal-title":"Int J Gynaecol Obstet"},{"key":"2025082801481792000_14.8.e244247.3","doi-asserted-by":"publisher","DOI":"10.1055\/s-0038-1666998"},{"key":"2025082801481792000_14.8.e244247.4","doi-asserted-by":"crossref","first-page":"4","DOI":"10.1016\/j.ijgo.2007.05.001","article-title":"The effect of urine on the endometrium","volume":"99","author":"Ingelman-Sundberg","year":"2007","journal-title":"Int J Gynaecol Obstet"},{"key":"2025082801481792000_14.8.e244247.5","doi-asserted-by":"crossref","first-page":"719","DOI":"10.1007\/s00192-007-0311-2","article-title":"Hormonal dependence of fistulas communicating with the uterus","volume":"18","author":"J\u00f3zwik","year":"2007","journal-title":"Int Urogynecol J Pelvic Floor Dysfunct"},{"key":"2025082801481792000_14.8.e244247.6","doi-asserted-by":"crossref","first-page":"37","DOI":"10.1080\/09513590310001651768","article-title":"The presence of sex hormone receptors in the vesicouterine fistula","volume":"18","author":"J\u00f3zwik","year":"2004","journal-title":"Gynecol Endocrinol"},{"key":"2025082801481792000_14.8.e244247.7","doi-asserted-by":"crossref","first-page":"196","DOI":"10.33545\/gynae.2019.v3.i1d.32","article-title":"Pregnancy with neglected Youssef syndrome a case report","volume":"3","author":"Ohri","year":"2019","journal-title":"Int J Clin Obstet Gynaecol"},{"key":"2025082801481792000_14.8.e244247.8","first-page":"189","article-title":"A case of vesicouterine fistula: unwanted medical anomaly but consequentiality of most-wanted medical intervention 'caesarean section'","volume":"8","author":"Bakshi","year":"2014","journal-title":"J Clin Diagn Res"},{"key":"2025082801481792000_14.8.e244247.9","first-page":"681","article-title":"Youssef\u2019s Syndrome","volume":"53","author":"Shinde","year":"2011","journal-title":"Bombay Hosp J"},{"key":"2025082801481792000_14.8.e244247.10","article-title":"Youssef's syndrome following cesarean section","volume":"2015","author":"Birge","year":"2015","journal-title":"Case Rep Obstet Gynecol"},{"key":"2025082801481792000_14.8.e244247.11","doi-asserted-by":"crossref","first-page":"132","DOI":"10.4103\/ais.ais_40_17","article-title":"Post-caesarean vesicouterine fistula: Youssef\u2019s syndrome \u2013 A case report","volume":"7","author":"Taingson","year":"2017","journal-title":"Arch Int Surg"},{"key":"2025082801481792000_14.8.e244247.12","doi-asserted-by":"crossref","unstructured":"Karadeli E , Kayahan Ulu EM , Tarhan NC . Vesicouterine Fistula (Youssef\u2019s syndrome): Imaging Findings. 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