Aruna Menon1, Prajakta S. Mehendale2, Srinivas Sangisapu3, Ajai Srivastava4, Shilpa Asthana5

Youssef’s syndrome, a rare entity, consists of cyclical haematuria or menouria, amenorrhea associated with vaginal leakage of urine. This was first described by M Youssef, an Egyptian Surgeon in 1957.1 Since then, reports of this rare urogenital fistula have appeared off and on in literature. We present a case subsequent to a ruptured uterus during a trial of labour after a previous Caesarean section.
A 26-year-old lady, para 2, presented to the OPD with complaints of intermittent haematuria, increased frequency of micturition and lactational amenorrhea. She also gave history of occasional watery discharge per vaginum, which had subsided by the time of presentation.
Her obstetric history revealed that she had 2 live children. The first pregnancy resulted in a caesarean section for breech presentation. During the subsequent pregnancy, she underwent an induction of labour for VBAC in a teaching hospital. This unfortunately resulted in a ruptured uterus following administration of dinoprostone gel and augmentation with oxytocin. A live male baby was delivered by emergency LSCS. The ruptured uterus was cruciate in nature extending up to the bladder and was repaired with Vicryl followed by tubectomy. No injury to the bladder was noticed at that time. She was treated with antibiotics and kept catheterised for 7 days. She had an uneventful hospital stay subsequently and was discharged after 10 days.