Bowel Obstruction Following Complex Fistula Repair: A Case Study and Literature Review

Retroureteral hernias are uncommon postoperative complications that can arise after surgical interventions. We present a case involving a 35-year-old woman who experienced a bladder and ureteral injury following an emergency cesarean section, leading to the formation of a vesicovaginal fistula. After undergoing fistula repair and ureteral reimplantation, she developed a bowel obstruction nearly two years later due to a retro ureteral hernia. A diagnostic laparoscopy revealed that the ureter had become intraperitoneal, causing the bowel to become entrapped. The surgical team successfully reduced the herniated bowel, retroperitonealized the ureter, and restored normal anatomy, resulting in the complete resolution of the patient’s symptoms and no evidence of ureteral obstruction on imaging.