{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,8,27]],"date-time":"2025-08-27T17:10:16Z","timestamp":1756314616830,"version":"3.44.0"},"reference-count":15,"publisher":"BMJ","issue":"2","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2024,11,20]]},"published-print":{"date-parts":[[2025,2]]},"abstract":"<jats:p>Vesicouterine fistula (VUF) is a rare complication following caesarean sections, often presenting with the classic triad of Youssef syndrome (urinary incontinence with cyclic haematuria (menouria) and amenorrhoea) but sometimes without typical symptoms. We report a case of a woman in her early 30s who developed VUF after an emergency lower segment caesarean section, complicated by necrotising soft tissue infection (NSTI) of the left forearm. One week post-surgery, she presented with NSTI symptoms and haematuria, which were managed with broad-spectrum antibiotics and debridement. During her hospital stay, she experienced persistent urinary incontinence and burning micturition. Evaluation of these symptoms revealed acute intestinal obstruction, and a contrast CT indicated vesicouterine communication. Surgical exploration confirmed a perforated uterus with possible retained placental tissue, and a VUF. Subtotal hysterectomy and bladder repair were performed, and her recovery was smooth. This case underscores the importance of considering VUF in patients with post-caesarean urinary symptoms, despite its rarity.<\/jats:p>","DOI":"10.1136\/bcr-2024-262560","type":"journal-article","created":{"date-parts":[[2025,2,24]],"date-time":"2025-02-24T23:55:36Z","timestamp":1740441336000},"page":"e262560","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["A complication of emergency caesarean section: delayed diagnosis of vesicouterine fistula with associated necrotising soft tissue infection and small bowel obstruction"],"prefix":"10.1136","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0009-0001-9473-3904","authenticated-orcid":false,"given":"Aayush","family":"Nagpal","sequence":"first","affiliation":[{"name":"Surgical Disciplines, All India Institute of Medical Sciences New Delhi, New Delhi, Delhi, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sakshi","family":"Dholpuria","sequence":"additional","affiliation":[{"name":"Surgical Disciplines, All India Institute of Medical Sciences New Delhi, New Delhi, Delhi, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8219-355X","authenticated-orcid":false,"given":"Devender","family":"Singh","sequence":"additional","affiliation":[{"name":"Surgical Disciplines, All India Institute of Medical Sciences New Delhi, New Delhi, Delhi, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sunil","family":"Chumber","sequence":"additional","affiliation":[{"name":"All India Institute of Medical Sciences, New Delhi, Delhi, India"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2025,2,24]]},"reference":[{"key":"2025082709540010000_18.2.e262560.1","doi-asserted-by":"crossref","first-page":"267","DOI":"10.1007\/s00192-007-0426-5","article-title":"Urogenital fistulae: changing trends and personal experience of 46 cases","volume":"19","author":"El-Lamie","year":"2008","journal-title":"Int Urogynecol J"},{"doi-asserted-by":"publisher","key":"2025082709540010000_18.2.e262560.2","DOI":"10.1111\/j.1464-410X.2007.07067.x"},{"key":"2025082709540010000_18.2.e262560.3","doi-asserted-by":"crossref","DOI":"10.3390\/medicina58010123","article-title":"Risk Factors for Urological Complications Associated with Caesarean Section-A Case-Control Study","volume":"58","author":"Radu","year":"2022","journal-title":"Medicina (Kaunas)"},{"key":"2025082709540010000_18.2.e262560.4","doi-asserted-by":"crossref","first-page":"275","DOI":"10.1007\/s00192-012-1798-8","article-title":"Vesicouterine fistulae: our experience of 17 cases and literature review","volume":"24","author":"Rajamaheswari","year":"2013","journal-title":"Int Urogynecol J"},{"key":"2025082709540010000_18.2.e262560.5","doi-asserted-by":"crossref","DOI":"10.3389\/fsurg.2017.00058","article-title":"Consider the Risk of Vesicouterine Fistula in the Event of Intermittent Fluid Vaginal Discharge after a Cesarean Section","volume":"4","author":"Talla","year":"2017","journal-title":"Front Surg"},{"doi-asserted-by":"publisher","key":"2025082709540010000_18.2.e262560.6","DOI":"10.1016\/0002-9378(57)90384-8"},{"key":"2025082709540010000_18.2.e262560.7","doi-asserted-by":"crossref","first-page":"184","DOI":"10.1016\/S0003-4401(03)00052-4","article-title":"Le syndrome de Youssef (fistule v\u00e9sico-ut\u00e9rine): \u00e0 propos de trois observations","volume":"37","author":"El Fassi","year":"2003","journal-title":"Ann Urol (Paris)"},{"key":"2025082709540010000_18.2.e262560.8","first-page":"3","article-title":"A Rare Cause of Urinary Incontinence: Vesicouterine Fistula-A Case Report","volume":"5","author":"Viorel Dragos","year":"2024","journal-title":"Womens Health Rep (New Rochelle)"},{"key":"2025082709540010000_18.2.e262560.9","doi-asserted-by":"crossref","first-page":"1163","DOI":"10.2298\/VSP1412163S","article-title":"Obstetric complications of placenta previa percreta","volume":"71","author":"Spari\u0107","year":"2014","journal-title":"Vojnosanit Pregl"},{"doi-asserted-by":"publisher","key":"2025082709540010000_18.2.e262560.10","DOI":"10.1111\/j.1464-410X.1985.tb06305.x"},{"unstructured":"Kadiri TR , Tukhtarov IT . Migration of the intrauterine contraceptive in the urinary bladder with formation of the secondary stone and vesicouterine fistula. 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