Postmyomectomy uterocutaneous fistula: a case report and literature review.

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Abstrakt

Tytuł:: Postmyomectomy uterocutaneous fistula: a case report and literature review.
Autorzy:: Han C; Department of Obstetrics and Gynecology, Qilu Hospital (Qingdao), Cheeloo College of Medicine, Shandong University, 758 Hefei Road, Qingdao, 266035, Shandong, China.
Zhang W; Department of Obstetrics and Gynecology, Qilu Hospital (Qingdao), Cheeloo College of Medicine, Shandong University, 758 Hefei Road, Qingdao, 266035, Shandong, China.
Li X; Department of Obstetrics and Gynecology, Qilu Hospital (Qingdao), Cheeloo College of Medicine, Shandong University, 758 Hefei Road, Qingdao, 266035, Shandong, China.
Sun B; Department of Obstetrics and Gynecology, Qilu Hospital (Qingdao), Cheeloo College of Medicine, Shandong University, 758 Hefei Road, Qingdao, 266035, Shandong, China.
Cheng L; Department of Obstetrics and Gynecology, Qilu Hospital (Qingdao), Cheeloo College of Medicine, Shandong University, 758 Hefei Road, Qingdao, 266035, Shandong, China. .
Źródło:: Archives of gynecology and obstetrics [Arch Gynecol Obstet] 2022 Apr; Vol. 305 (4), pp. 1099-1103. Date of Electronic Publication: 2022 Jan 21.
Typ publikacji:: Case Reports; Journal Article; Review
Język:: English
Imprint Name(s):: Publication: Berlin : Springer Verlag
Original Publication: München : Springer International, c1987-
MeSH Terms:: Fistula*/diagnosis
Fistula*/etiology
Fistula*/surgery
Uterine Myomectomy*
Adult ; Conservative Treatment ; Female ; Gonadotropin-Releasing Hormone/agonists ; Humans
References:: Shah N, Changede P, More V (2019) Laparoscopic management of post-cesarean section uterocutaneous fistula. J Obstet Gynaecol India 69(4):380–382. https://doi.org/10.1007/s13224-018-1197-2. (PMID: 10.1007/s13224-018-1197-2313917496661046)
Pratibha S, Rajni B (2015) Uterocutaneous fistula following septic abortion: can it heal without major surgical intervention? J Obstet Gynaecol 35(6):651–652. https://doi.org/10.3109/01443615.2014.989822. (PMID: 10.3109/01443615.2014.98982225526507)
Akkurt MÖ, Yavuz A, Tatar B, Özkaya MO, Ekici Eİ (2015) Uterocutaneous fistula after multiple abdominal myomectomies: a case report. Balkan Med J 32(4):426–428. https://doi.org/10.5152/balkanmedj.2015.151206. (PMID: 10.5152/balkanmedj.2015.151206267409054692345)
Seyhan A, Ata B, Sidal B, Urman B (2008) Medical treatment of uterocutaneous fistula with gonadotropin-releasing hormone agonist administration. Obstet Gynecol 111(2 Pt 2):526–528. https://doi.org/10.1097/01.AOG.0000281670.94265.5c. (PMID: 10.1097/01.AOG.0000281670.94265.5c18239009)
Thubert T, Denoiseux C, Faivre E, Naveau A, Trichot C, Deffieux X (2012) Combined conservative surgical and medical treatment of a uterocutaneous fistula. J Minim Invasive Gynecol 19(2):244–247. https://doi.org/10.1016/j.jmig.2011.10.010. (PMID: 10.1016/j.jmig.2011.10.01022381970)
Yadav P, Gupta S, Singh P, Tripathi S (2014) Successful medical management of uterocutaneous fistula. Int J Gynaecol Obstet 124(3):263–264. https://doi.org/10.1016/j.ijgo.2013.09.024. (PMID: 10.1016/j.ijgo.2013.09.02424405990)
Min KJ, Lee J, Lee S, Lee S, Hong JH, Song JY, Lee JK, Lee NW (2018) Uterocutaneous fistula after pelviscopic myomectomy-successful diagnosis with hystero-salpingo contrast sonography and complete tract resection and medical treatment for fertility preservation in young woman: a case report. Obstet Gynecol Sci 61(5):641–644. https://doi.org/10.5468/ogs.2018.61.5.641. (PMID: 10.5468/ogs.2018.61.5.641302550036137022)
Yesiladali M, Saridogan E, Saridogan E (2019) Successful pregnancy and delivery following surgical treatment of postmyomectomy uterocutaneous fistula. BMJ Case Rep 12(12):e231594. https://doi.org/10.1136/bcr-2019-231594. (PMID: 10.1136/bcr-2019-231594318111076904194)
Anderson KB, Søgaard-Andersen E, Aleksyniene R, Frandsen AP (2020) Spontaneous utero-cutaneous fistula between a benign uterine leiomyoma and abdominal skin: a case report. Case Rep Women’s Health 29:e00282. https://doi.org/10.1016/j.crwh.2020.e00282. (PMID: 10.1016/j.crwh.2020.e00282)
Dragoumis K, Mikos T, Zafrakas M, Assimakopoulos E, Stamatopoulos P, Bontis J (2004) Endometriotic uterocutaneous fistula after cesarean section. A case report. Gynecol Obstet Invest 57(2):90–92. https://doi.org/10.1159/000075384. (PMID: 10.1159/00007538414671417)
Ilyas M, Khan I, Gojwari T, Dar MA, Shafi F, Shah OA (2019) Post-LSCS uterocutaneous fistula-utility of magnetic resonance imaging in its diagnosis. Turk J Obstet Gynecol 16(2):133–135. https://doi.org/10.4274/tjod.galenos.2019.29560. (PMID: 10.4274/tjod.galenos.2019.29560313605896637778)
Jozwik M, Jozwik M, Sulkowska M, Musiatowicz B, Sulkowski S (2004) The presence of sex hormone receptors in the vesicouterine fistula. Gynecol Endocrinol 18(1):37–40. https://doi.org/10.1080/09513590310001651768. (PMID: 10.1080/0951359031000165176815106363)
Jóźwik M, Jóźwik M (1999) Spontaneous closure of vesicouterine fistula. Account for effective hormonal treatment. Urol Int 62(3):183–187. https://doi.org/10.1159/000030388. (PMID: 10.1159/00003038810529673)
Contributed Indexing:: Keywords: Conservative treatment; Gonadotropin-releasing hormone agonist; Uterocutaneous fistula
Substance Nomenclature:: 33515-09-2 (Gonadotropin-Releasing Hormone)
Entry Date(s):: Date Created: 20220121 Date Completed: 20220401 Latest Revision: 20220510
Update Code:: 20240105
DOI:: 10.1007/s00404-022-06400-y
PMID:: 35061065
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Background: Uterocutaneous fistula (UCF) is an uncommon clinical entity. The aetiology and optimal treatment strategy of UCF are still not clear. GnRHa (gonadotropin-releasing hormone agonist) treatment as an option for conservative hormone therapy for UCF has diverse clinical outcomes. The true status of hormone receptors in UCF lesions and its relationship with the therapeutic effect of GnRHa treatment have not yet been studied.
Case Presentation and Review of the Literature: A 39-year-old woman underwent an uneventful myomectomy during her initial visit to our centre. The patient returned to our centre with complaints of fluid oozing from her abdominal wound. Misdiagnosed with poor wound healing, the patient received a secondary closure. Consequent blood-stained drainage from the wound during menstruation and imaging tests confirmed the diagnosis of UCF. Surgical repair and excision of the fistula tract were performed. Histopathological analysis revealed fistulization and a negative status of hormone receptors in the fistula. Considering the controversial role of GnRHa treatment in UCF and the negative oestrogen receptor (ER) and progesterone receptor (PR) status in the current case, we further systematically reviewed the literature for GnRHa treatment for UCF, with the results showing that GnRHa manipulation as a conservative hormone therapeutic schedule is effective in 2 (50%) of the 4 patients in which it was attempted.
Conclusion: UCF is a rare entity and tends to be misdiagnosed. GnRHa as a conservative therapy for UCF has different clinical outcomes. The current finding of a negative hormone receptor status in the fistula may provide new clues for further exploration of the mechanisms of the diverse therapeutic effects of GnRHa on UCF.
(© 2022. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

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