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An inventive two-catheter technique to manage an extra-peritoneally ruptured and prolapsed bladder causing
Mick O'Halloran1, Steve McCombie1, Dickon Hayne1,2
1Fiona Stanley Hospital Urology Department, Perth, WA, Australia.
Urology Case Reports
|June 19, 2019
Summary
An elderly woman with bladder prolapse experienced rupture after a fall. A novel dual-catheter approach successfully reduced the prolapse, resolving ureteric obstruction and preventing recurrence with a pessary.
Area of Science:
- Urology
- Geriatric Medicine
- Pelvic Floor Disorders
Background:
- Elderly female patient presented with extraperitoneal bladder rupture.
- Rupture occurred after a fall in the context of uterine procidentia.
- Procidentia caused long-standing bilateral ureteric obstruction.
Observation:
- An 84-year-old female presented with extraperitoneal bladder rupture following a fall, superimposed on severe procidentia.
- Imaging revealed a significant portion of the bladder residing within the prolapsed tissue, causing bilateral ureteric obstruction.
Findings:
- Initial catheterization of the pelvic bladder portion achieved partial decompression.
- A second urethral catheter placed into the prolapsed bladder component facilitated manual reduction of the prolapse.
- Successful prolapse reduction resolved the ureteric obstruction, with maintenance achieved using a pessary.
Implications:
- This case highlights a unique presentation of bladder rupture associated with pelvic organ prolapse.
- A dual-catheter technique offers a minimally invasive solution for managing complex bladder distension within prolapsed organs.
- Pessary management can effectively maintain prolapse reduction and prevent recurrence of ureteric obstruction.
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