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Youssef's syndrome: an appraisal of hormonal treatment.

Two cases of vesicouterine fistula, caused by lower-segment cesarean section, are presented. Both cases had classical symptoms of Youssef's syndrome, i.e. cyclic hematuria, absence of vaginal bleeding and complete urinary continence. These patients were treated by the continuous administration of an estrogen-progestogen combination for 6 months. However, it failed in 1 case requiring transabdominal transperitoneal closure of the fistula with an interposition of omentum. We feel that hormonal treatment may be tried as first modality in the treatment of Youssef's syndrome, before resorting to surgery.