Abstract
Objective:Bladder rupture caused by transurethral clot evacuation is rare in clinic, but an emergency operation is indeed needed in the patient with bladder rupture. We analyzed the reasons of bladder rupture caused by transurethral clot evacuation and provided the countermeasures to guide clinical surgeon to prevent the iatrogenic damage of bladder.Method:We retrospectively reviewed the records of 287 patients in our hospital, who had bladder tamponade resulting from clots of blood for various reasons and underwent transurethral clot evacuation from January 2007 to January 2019. Six male cases, aged from 28 to 76 years (mean 56.67±17.76) had bladder rupture. Four patients whose bladder ruptured intraperitoneally were changed to open surgery to repair bladder and clear the remanent blood clots. Two patients with extraperitoneal bladder rupture and a small bladder crevasse underwent a conservative therapy.Results:We observed that the incidence rate of bladder rupture was not associated with bladder tamponade and the age, but may be associated with gender, bladder paracentesis preoperative and urinary retention preoperative. All six cases were male.. They had different period of urinary retention before operation. No supra-pubis bladder paracentesis was made before operation. The bladder crevasses located in the triangle zone and posterior wall of bladder entirely, and the length of the bladder crevasses ranged from 3 to 7cm (mean 4.83cm). The bladder crevasses were all lengthways, and four cases were of’ bladders ruptured intraperitoneally while another two presented an extraperitoneal bladder rupture.Conclusions:The reasons of bladder rupture caused by transurethral clot evacuation may be related to gender, bladder paracentesis preoperative and urinary retention preoperative. We should decide to use expectant treatment or open surgery immediately according to the extent of the rupture when bladder rupture occurs.
Highlights
Bladder rupture is the frequent acute abdomen of urology, and it’s usually caused by trauma, road accident, gunshot and iatrogenic operation.[1,2,3,4,5,6] The bladder is the most common injury in genitourinary organ that from blunt pelvic trauma.[7]
Bladder rupture caused by transurethral clot evacuation is rare in clinic, but an emergency operation is needed in the patient with bladder rupture
The incidence of bladder rupture was not associated with the reason of bladder tamponade and the age, but may be associated with gender, bladder paracentesis preoperative and urinary retention preoperative
Summary
Bladder rupture is the frequent acute abdomen of urology, and it’s usually caused by trauma, road accident, gunshot and iatrogenic operation.[1,2,3,4,5,6] The bladder is the most common injury in genitourinary organ that from blunt pelvic trauma.[7] Bladder trauma is seldom an isolated injury and it is frequently missed in poly-trauma cases because we pay more. Attention to life-threatening injuries like head injury, tension pneumothorax, hemothorax and hemoperitoneum.[2,8,9] Bladder rupture caused by transurethral clot evacuation is rare in clinic, but an emergency operation is needed in the patient with bladder rupture. We analyzed the reasons of patients with bladder rupture caused by transurethral clot evacuation, and provided the countermeasures to prevent the iatrogenic damage of bladder while doing the transurethral procedure using the endoscope
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
