Meanwhile, she had secondary amenorrhea due to breastfeeding; thus no menstrual bleeding and no cyclic hematuria (menouria) were reported.
The clinical manifestations vary from cyclic hematuria (menouria), amenorrhea, vaginal leakage of urine, with or without urinary incontinence, and recurrent urinary tract infections associated with low-grade pyrexia to secondary infertility and first-trimester abortion [1, 2, 4-6].
Clinical presentations of vesicouterine fistulas may be early or late and are mostly represented by amenorrhea, urinary incontinence, and macroscopic hematuria during menstruation (menouria) [2, 9].
Subsequently, due to resolution of symptoms the patient stopped seeking medical attention, although she periodically suffered from urinary incontinence, menouria, and recurrent infection of lower urinary tract.
In one case the repair was performed after 13 years of urinary incontinence with menouria
. The only case of urethrovaginal fistula was treated with interpositional Martius flap.
Cystoscopy performed during the period of menouria revealed an orifice of size about 8mm in the supratrigonal area in midline.
A case of primary menouria due to congenital vesicouterine fistula with distal vaginal agenesis was reported by Singh V.
It was thought that cyclic hematuria of the patient was menouria and the patient was diagnosed with VUF (Youssef syndrome) seen after cesarean section.
(12) In Type 1, there is amenorrhea with menouria (cyclic hematuria) and it is named as Youssef syndrome.
IUD migration into adjacent organs leads to bowel obstruction, peritoneal perforation, appendicitis, vesical calculus formation, obstructive nephropathy, fistula formation, menouria
, and intraperitoneal adhesions that can lead to infertility [11, 19].
Spontaneous vesicouterine fistula has been reported after vaginal delivery following a previous Cesarean section.[sup.3] Main presenting symptoms are urinary incontinence, amenorrhea, and menouria
. Conservative treatment may be applied in some cases, but surgery is the definitive treatment.
The patient did not report cyclic menouria
. Her past obstetric history was significant for 2 prior Cesarean sections.