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Traumatic bladder rupture following vaginal hysterectomy
Claire Griffiths1, Christina Lewicky-Gaupp, Dee E Fenner
1From the Division of Gynecology, Department of Obstetrics and Gynecology, University of Michigan Medical School, Ann Arbor, MI.
Female Pelvic Medicine & Reconstructive Surgery
|March 29, 2012
Summary
Bladder injuries during vaginal hysterectomy are uncommon but can lead to serious complications like urinoma. Early recognition and surgical repair are crucial for managing these rare events.
Area of Science:
- Gynecology
- Urology
- Surgical Complications
Background:
- Bladder injury is a rare but significant complication of vaginal hysterectomy.
- Adhesions from prior cesarean sections increase the risk of bladder injury during uterine mobilization.
- Potential clinical presentations include urinary retention, hematuria, and abdominal pain.
Purpose of the Study:
- To report a case of unrecognized bladder injury during vaginal hysterectomy.
- To highlight the development of an abdominopelvic urinoma secondary to bladder rupture.
- To emphasize the importance of prompt diagnosis and surgical management.
Main Methods:
- A total vaginal hysterectomy was performed.
- An unrecognized bladder injury occurred during the procedure.
- The patient subsequently developed an abdominopelvic urinoma.
Main Results:
- The bladder injury was initially unrecognized.
- The unrecognized injury led to a significant urinoma formation.
- Surgical drainage and repair of the urinoma were required.
Conclusions:
- Vaginal hysterectomy carries a risk of bladder injury, even if rare.
- Unrecognized bladder injuries can result in urinoma, necessitating surgical intervention.
- Vigilance for and prompt management of bladder injuries are essential in gynecologic surgery.
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