Traumatic bladder rupture following vaginal hysterectomy

Although complications associated with vaginal hysterectomy are rare, the most common complications involve bladder injury. These injuries are sustained most commonly during mobilization of the posterior bladder wall off of the lower uterine segment, particularly in the setting of adhesions from prior cesarean sections. Bladder injuries may present with urinary retention, gross hematuria, serum electrolyte, and creatinine abnormalities, a bowel ileus or abdominal pain. This report describes a patient who underwent a total vaginal hysterectomy complicated by an unrecognized bladder injury, rupture, and subsequent abdominopelvic urinoma, requiring surgical drainage and repair.