Despite the widespread use, abdominal delivery is considered to be a complex surgical intervention with a high frequency of complications. According to the world literature, every four women give birth by caesarean section and every five of them have postoperative complications. Urinary system organs are injured in on average 2—12% of cases during cesarean section. The nature and volume of preoperative preparation, the volume of surgical intervention and, ultimately, the outcome of the disease depend on the correct and accurate diagnosis. The paper describes 2 clinical cases of patients with vesicouterine fistula after a caesarean section, who showed different clinical courses: one case had a severe pyonecrotic process in the small pelvis, the other had no signs of endometritis and uterine tissue destruction.