During the laparohysteroscopic procedure the pelvis was inspected including uterus, fallopian tube, round ligaments, uterovesical pouch, uterosacral ligaments and Pouch of Douglas.
Panoramic laparoscopic pelvic view shows the uterus, tubes, both ovaries, and uterovesical and Douglas pouches, in addition to both the parietal and the visceral peritoneum, to detect any abnormality concerning the size, shape, and mobility.
The obtained fluid (3-5 ml) was aspirated under direct vision, from either the Douglas or uterovesical pouch, with a nylon catheter, at the beginning of the surgery, after trocar introduction, and was placed in sterile heparinized tubes (Greiner).
(1) Most uterine fistulae are between the uterine and the bladder or bowel (uterovesical or uterocolonic) due to postoperative injuries or infectious conditions.
During intra-operative period after opening pouch of douglous and uterovesical pouch, there was difficulty in delivering out the uterus as there was the adhesions of omentum with anterior surface of body of the uterus.