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VESICO-UTERINE FISTULA: A RARE CASE REPORT Presenting author: Dr. Dhatri Chatterjee (Postgraduate) Co-author: Dr. K. Vandana (Prof & HOD, OBGY) INTRODUCTION Vesico-uterine fistula represents least common type (1-4%) of urogenital fistulas. It can occur due to obstetrical, surgical, radiation necrosis or malignancy related causes. Definitive treatment is surgery in most cases. AIM: To present a rare case report of vesico-uterine fistula MATERIALS AND METHODS: A 24yr old P2L2 with POD- 5 of Repeat emergency LSCS, referred from private hospital, with c/o hematuria since POD-4. On POD-5, cystoscopy was performed: 1cm rent was seen in middle at dome of the bladder with minimal slough formation. On POD 7, CECT was performed: defect of size approx. 2.4cm was noted on anterior wall of LUS with fistulous communication with Urinary bladder- s/o vesico-uterine fistula. RESULTS: INVESTIGATIONS: CBP, CUE, Blood grouping, RBS,Viral markers, Coagulation profile: Within normal limits. Ultrasound, Cystoscopy, CECT. MANAGEMENT: Exploratory Laparotomy with Bladder Injury Repair & Vesico-uterine fistula Repair was performed on POD ? 10. Post operative period was uneventful. She was discharged with Foley?s catheter in-situ for 1 month. CONCLUSION: VUF is a rarely encountered & least common type of uro-gynecological fistula. However, with the increasing rate of repeat caesarean deliveries, gynaecologists need to be aware of this complication. Timed Cesarean section & correct identification of tissues during cesarean section is important. It is diagnosed clinically and confirmed by HSG/cystoscopy/CT scan. Treatment is often surgical with an excellent cure rate.