Conservative management of postoperatively diagnosed cystotomy.
Bladder injury is a common complication of hysterectomy that is often not recognized at the initial surgery. The conventional approach to intraperitoneal cystotomy is surgical repair. The goal of this case series was to introduce an alternative conservative treatment of posthysterectomy cystotomy. We present 3 cases of posthysterectomy cystotomy that were unrecognized at the initial surgery and were treated with assisted bladder drainage. The treatment of iatrogenic intraperitoneal cystotomy with bladder drainage facilitated complete healing and eliminated the need for surgical repair. We suggest that conservative management be considered as the first-line treatment option in appropriately selected patients.
Division of Female Pelvic Medicine and Reconstructive Surgery, Magee-Womens Hospital of University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA. malperin@mail.magee.edu
Marianna
M
Alperin
Gina
G
Mantia-Smaldone
Elizabeth R
ER
Sagan
D000328:Adult; D003558:Cystoscopy / Q000379:methods; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007044:Hysterectomy / Q000009:adverse effects* / Q000379:methods; D007431:Intraoperative Complications; D007889:Leiomyoma / Q000175:diagnosis / Q000601:surgery; D008875:Middle Aged; D011183:Postoperative Complications / Q000175:diagnosis* / Q000628:therapy; D018570:Risk Assessment; D016896:Treatment Outcome; D001743:Urinary Bladder / Q000293:injuries*; D001745:Urinary Bladder Diseases / Q000209:etiology / Q000628:therapy*; D014546:Urinary Catheterization / Q000379:methods*; D014594:Uterine Neoplasms / Q000175:diagnosis / Q000601:surgery