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  2. Vol 30, No 8 (2026)
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Diagnosis and management of uterocutaneous fistula following cesarean section: A case report

Jawaher Hammadi(1), Soukeina Jaballah(2), Yasmine B. Ali(3), Jihene B. Haj(4), Nour Rouis(5), Samar Knaz(6), Sana Ghades(7), Mohamed R. Fatnassi(8),


(1) Department of gynecology and obstetrics, University Hospital’s Ibn El Jazzar, Kairouan, Tunisia; University of medicine Ibn El Jazzar, Sousse, Tunisia
(2) Department of gynecology and obstetrics, University Hospital’s Ibn El Jazzar, Kairouan, Tunisia; University of medicine Ibn El Jazzar, Sousse, Tunisia
(3) Department of gynecology and obstetrics, University Hospital’s Ibn El Jazzar, Kairouan, Tunisia; University of medicine Ibn El Jazzar, Sousse, Tunisia
(4) Department of gynecology and obstetrics, University Hospital’s Ibn El Jazzar, Kairouan, Tunisia; University of medicine Ibn El Jazzar, Sousse, Tunisia
(5) Department of gynecology and obstetrics, University Hospital’s Ibn El Jazzar, Kairouan, Tunisia; University of medicine Ibn El Jazzar, Sousse, Tunisia
(6) Department of gynecology and obstetrics, University Hospital’s Ibn El Jazzar, Kairouan, Tunisia; University of medicine Ibn El Jazzar, Sousse, Tunisia
(7) University of medicine Ibn El Jazzar, Sousse, Tunisia
(8) Department of gynecology and obstetrics, University Hospital’s Ibn El Jazzar, Kairouan, Tunisia; University of medicine Ibn El Jazzar, Sousse, Tunisia
Corresponding Author

Abstract


Uterocutaneous fistula following cesarean delivery is an exceptionally rare complication, defined by an abnormal tract between the uterine cavity and the abdominal scar. We report a 28-year-old woman who presented three months and half after a cesarean section with cyclical bloody discharge from a Pfannenstiel scar, preceded by a superficial wound infection. Pelvic magnetic resonance imaging (MRI) precisely delineated the tract, revealing a 21 mm anterior uterine wall defect communicating with a 25 mm subcutaneous collection, and informed surgical planning. Management included complete fistulectomy with layered uterine repair, followed by a three month course of a gonadotropin-releasing hormone (GnRH) analogue. Postoperative recovery was uneventful, with no recurrence during follow-up. This case highlights an infection-associated delayed presentation and illustrates the value of quantitative MRI mapping combined with short-course hormonal suppression to achieve durable closure while preserving fertility.

References


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