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Background: Vesicouterine fistula is rare. We report a vesicouterine fistula that was the direct result of a vaginal delivery in a patient with a history of lower uterine segment cesarean delivery.

Case: A woman developed a vesicouterine fistula during vaginal delivery after a previous cesarean. An anterior uterine wall defect was noted immediately after the delivery. Continuous bladder drainage was unsuccessful in managing her fistula, and surgical correction was necessary.

Conclusion: Although rare, a vesicouterine fistula can occur as a complication of vaginal delivery in patients with a history of cesarean delivery.

(C) 1995 The American College of Obstetricians and Gynecologists