Partially Removed Ureteral Stent Complicated by Bladder Stone and Vesico-vaginal Fistula : Endoprothèse Urétérale Partiellement Retirée Compliquée d’un Calcul Vésical et d’une Fistule Vésico-vaginale

Abstract

During surgery for obstetric fistulas, particularly ureterovaginal fistulas, the ureters are catheterized using ureteral stents. The catheter is usually attached to the bladder mucosa and can be difficult to remove. Unremoved catheters can lead to urinary tract infections and bladder lithiasis. This study aims to present a partial removal of a ureteral catheter that was complicated by the formation of lithiasis, and which lithiasis created a vesicovaginal fistula. A 21-year-old patient, G2P2000, developed an obstetric fistula after her second delivery by cesarean section. She underwent ureterovesical reimplantation indicated for iatrogenic fistula in 2019 with the restoration of good urinary continence. In 2024, she was admitted to Maroua Regional Hospital for pelvic pain and involuntary vaginal urine leakage. She was diagnosed with a vesicovaginal fistula caused by a bladder stone. Intraoperatively, we extracted a large 60 x 50 x 40 mm vesical lithiasis formed on a ureteral stump that had remained in the urinary tract since the last fistula cure in 2019. After the removal of the stone and catheter, repair of the fistula was deferred due to the infectious context caused by the foreign body. The ureteral catheter must be fixed to the bladder mucosa with a small-gauge, rapidly resorbing suture to avoid retention and related complications.