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Year : 2017  |  Volume : 9  |  Issue : 2  |  Page : 125-130

Immediate ureterovaginal fistula following oocyte retrieval: A case and systematic review of the literature

1 Department of Urology, University of North Carolina, Chapel Hill, USA
2 Department of Obstetrics and Gynecology, University of North Carolina, Chapel Hill; UNC Fertility, Raleigh, North Carolina, USA
3 Department of Urology; Obstetrics and Gynecology, University of North Carolina, Chapel Hill; UNC Fertility, Raleigh, North Carolina, USA

Correspondence Address:
Elysia Sophie Spencer
Department of Urology, University of North Carolina, 170, Manning Drive, 2115, Physicians Office Building, CB#7235, Chapel Hill, North Carolina
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DOI: 10.4103/UA.UA_122_16

PMID: 28479761

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The aim of this study is to report a case of acute ureterovaginal fistula (UVF) formation with immediate symptomatic presentation after transvaginal ultrasound-guided oocyte retrieval (TVOR) for in vitro fertilization (IVF) and to perform a systematic literature review of ureteral injuries during TVOR. A 33-year-old woman with a history of anovulatory infertility presented with severe abdominal pain and vaginal leakage immediately following TVOR for IVF. We systematically reviewed the current literature regarding ureteral injury resulting from TVOR and present a case of timely identification and management of a UVF followed by a successful pregnancy. Computed tomography cystogram with intravenous contrast and left retrograde pyelogram confirmed the diagnosis of UVF which was managed by placement of the left ureteral stent. The IVF cycle was converted to a freeze-all cycle. The ureteral stent was removed 4 weeks later, and a subsequent frozen embryo transfer cycle resulted in pregnancy. We present the 13th case of ureteral injury and the fourth case of UVF following TVOR. UVF formation is a rare complication after TVOR and may result in serious long-term morbidity if it is not identified and treated promptly. Clinicians must exercise a high degree of suspicion and prompt evaluation for potential ureteral injuries in women presenting with abdominal pain, urinary symptoms, or vaginal leakage following TVOR.

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