Menouria, also called Youssef syndrome, is an uncommon condition in which a vesicouterine fistula results in cyclic hematuria. Vesicouterine fistulas are the rarest of all urinary fistulas, accounting for just 4% of all such fistulas 3. It occurs most commonly after cesarean section.
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Clinical presentation
- cyclic hematuria
- possible absence of vaginal bleeding during menstruation
Pathology
Etiology
The most common cause of vesicouterine fistula is lower uterine segment Cesarean section (LUSCS). Other causes include:
- contraceptive device 4
- malignancy
- inflammation
- uterine rupture due to obstructed labor 5
- radiation therapy
- iatrogenic trauma, e.g. urinary catheterization
Radiographic features
A connection between the uterus and bladder may be evident on cystography (conventional or CT), or with hysterography.
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