[A CASE OF REFRACTORY BLADDER HEMORRHAGE AFTER GASTROCYSTOPLASTY].

Area of Science:

• Urology
• Surgical Innovation
• Nephrology

Background:

• Gastrocystoplasty, a historical bladder augmentation technique, can lead to severe complications.
• Hematuria-dysuria syndrome is a known, albeit rare, postoperative complication.
• Long-term management of augmented bladders in patients with renal failure presents unique challenges.

Purpose of the Study:

• To report a case of refractory bladder hemorrhage secondary to hematuria-dysuria syndrome after gastrocystoplasty.
• To describe the successful surgical management of this complication.
• To emphasize the need for caution with gastrocystoplasty in specific patient populations.

Main Methods:

• A 34-year-old male patient with a history of gastrocystoplasty and kidney transplantation presented with severe bladder hemorrhage.
• Conservative management including continuous bladder irrigation and vascular embolization was attempted.
• The patient ultimately underwent a partial cystectomy for definitive hemostasis.

Main Results:

• Refractory bladder hemorrhage due to hematuria-dysuria syndrome occurred in a patient with a history of gastrocystoplasty.
• Initial conservative treatments and vascular embolization failed to achieve hemostasis.
• Partial cystectomy successfully controlled the hemorrhage, achieving hemostasis.

Conclusions:

• Partial cystectomy can be an effective treatment for refractory bladder hemorrhage after gastrocystoplasty.
• Gastrocystoplasty carries risks, including hematuria-dysuria syndrome, necessitating careful patient selection.
• Caution is advised when considering gastrocystoplasty in patients with anuria or renal failure.