Complete Bladder Eversion after Colpocleisis

• Published in: International Urogynecology Journal 2024-04, Vol.35 (4), p.925-928
• Main Authors: Nicola-Ducey, Lauren, Gregory, W. Thomas, Cichowski, Sara, Sajadi, Kamran P.
• Format: Article
• Language: English
• Subjects: Aged; Bladder; Female; Gynecologic Surgical Procedures - methods; Gynecology; Humans; Images in Urogynecology; Laparotomy; Medicine; Medicine & Public Health; Postoperative Complications - etiology; Postoperative Complications - surgery; Urinary Bladder - surgery; Urinary Bladder Diseases - surgery; Urology; Vagina - surgery
• ISSN: 0937-3462; 1433-3023; 1433-3023
• DOI: 10.1007/s00192-024-05753-z

Background Because complete urinary bladder eversion is rare, a medical dilemma exists on the optimal treatment approach. The most extensive cases of this disorder have required a laparotomy for definitive management. Our transvaginal approach in this case provides an additional surgical perspective, which could potentially guide clinical care for patients with this disorder. Case We cared for a 76-year-old multiparous, postmenopausal woman with transurethral bladder eversion following a Le Fort colpocleisis, who presented with vaginal pain, bleeding, and renal failure. We used a transvaginal surgical approach rather than laparotomy as a novel surgical approach for treatment of the bladder eversion, which resulted in improved symptoms and renal function. We describe our diagnostic and decision making approach used for the care of this unique patient. Conclusion Transvaginal bladder neck closure and suprapubic catheter placement is an acceptable and less invasive alternative to the laparotomy with cystopexy for the surgical management of recurrent bladder eversion.