What question did this study set out to answer?

To present a rare case of uterocutaneous fistula after cesarean section and discuss its diagnosis and management.

May 1, 2026

Diagnosis and management of uterocutaneous fistula following cesarean section: A case report.

Key Points

To present a rare case of uterocutaneous fistula after cesarean section and discuss its diagnosis and management.
Described a case of a 28-year-old woman with an abnormal tract detected using pelvic MRI.
Surgical intervention involved complete fistulectomy and layered uterine repair and a postoperative course of GnRH analogue.
Follow-up assessed recovery and recurrence.
MRI imaging identified a 21 mm uterine wall defect and a 25 mm subcutaneous collection.
Postoperative follow-up indicated no recurrence of the fistula over three months.
Management approach combined surgical and hormonal therapies to maintain fertility.

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. (Afr J Reprod Health 2026; 30 8: 140-146).

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