Complete urethrovesical disruption following obstructed labor.

Area of Science:

• Urology
• Obstetrics & Gynecology
• Trauma Surgery

Background:

• Obstructed labor is a significant obstetric complication, particularly in resource-limited settings.
• Urethral and bladder injuries can occur during childbirth, but complete urethrovesical disruption is exceedingly rare.
• Literature primarily associates urethral disruption with direct trauma, not typically with obstructed labor.

Observation:

• A 22-year-old female presented with obstructed labor and suspected bladder/urethral injury.
• Laparotomy revealed complete urethral disruption at the vesicourethral junction and an anterior vaginal tear.
• The fetus had migrated into the extraperitoneal space, causing urethrovesical disruption due to pressure against the pubic symphysis.

Findings:

• Complete urethral disruption at the vesicourethral junction secondary to obstructed labor.
• Successful surgical management achieved through end-to-end anastomosis.
• This represents a unique case report of such severe injury resulting from obstructed labor.

Implications:

• This case expands the known etiological spectrum for complete urethral disruption.
• Highlights the potential for severe genitourinary trauma even in the absence of direct physical injury.
• Emphasizes the need for prompt diagnosis and surgical intervention in cases of obstructed labor with suspected injury.
• Discusses surgical options for managing complex urethrovesical disruptions.