Youssef’s syndrome following caesarean section: a rare case with review of literature

Vikas Devkare, Meenakshi Gothwal, Nandkishor Gaikwad, Sushil Pawar, Neha Agrawal, Ashwini Desai


Youssef’s syndrome is a rare condition characterized by vesicouterine fistula with cyclic haematuria, amenorrhoea and incontinence of urine. A vesicouterine fistula is an abnormal connection between the uterus and bladder that most commonly occur due to inadvertent injury to the bladder during lower segment caesarean section. Vesicouterine fistula leads to psychological and has the negative impact on quality of life. A high suspicion should be kept in mind if the patient presents with urinary incontinence even many years after caesarean section. However, conservative management may be appropriate in some cases, but the definitive mode of management is surgery. Hereby authors present a 22-year-old para 2 live 2 (previous 2 caesarean section) with vesicouterine fistula with the complaint of urinary incontinence, cyclical haematuria (menouria) and amenorrhoea a year after caesarean section done due to obstructed labour.



Menouria, Urinary incontinence, Vesicouterine fistula, Youssef syndrome

Full Text:



Nerli R, Patne P, Joshi K, Dixit N, Hiremath M. Vesicouterine fistula: a case report. J Sci Soc. 2015;42(1).

Ramamurthy S, Vijayan P, Rajendran S. Sonographic diagnosis of a uterovesical fistula. J Ultrasound Med. 2002;21:817-9.

Birge O, Ozbey EG, Erkan MM, Arslan D, Kayar I. Youssef’s syndrome following cesarean section. Case Rep Obstet Gynecol. 2015;2015.

Ikechebelu JI, Ugboaja JO, Okeke CF. Post‐cesarean vesicouterine fistula (Youssef syndrome): report of two cases. J Obstet Gynaecol Res. 2011;37(7):912-5.

Celdrán JO, Valverde FM. After Cesarean vesicouterine fistula (Youssef Syndrome) with successful conservative management. Urogynaecol. 2017;30(1).

Milani R, Cola A, Frigerio M, Manodoro S. Repair of a vesicouterine fistula following cesarean section. Int Urogynecol J. 2018;29(2):309-11.

Park OR, Kim TS, Kim HJ. Sonographic diagnosis of vesicouterine fistula. Ultrasound Obstet Gynecol. 2003;22:82-4.

Youssef AF. Menouria following lower segment cesarean section: a syndrome. Am J Obstet Gynecol. 1957;73:759.

Tancer ML. Vesicouterine fistula--a review. Obstet Gynecol Survey. 1986;41(12):743-53.

Chang-Jackson SC, Acholonu Jr UC, Nezhat FR. Robotic-assisted laparoscopic repair of a vesicouterine fistula. JSLS. 2011;15(3):339-42.