Laparoscopic Management of Bladder Injury During Total Laparoscopic Hysterectomy

Abstract

Objective: The rate of bladder injury during laparoscopic hysterectomy (LH) is three-fold higher than that of ureter injury and is an important problem for gynecologists. The aim of the present study was to present the results of laparoscopic repair of bladder injuries produced during LH procedure. Methods: Patients who underwent LH for benign indications between November 2018 and January 2020 were evaluated retrospectively. Medical records of all patients with bladder injury were reviewed and their causes of injury, incidence, treatment and follow-up were evaluated. Results: Eight patients were established to have bladder injury while undergoing LH. All bladder injuries were recognized during operation. Bladder injury occurred during laparoscopic sharp and blunt dissection of uterovesical area in seven patients and during suprapubic trochar insertion in one patient. All bladder injuries were repaired laparoscopically. No major complications were encountered during or after operation. Bladder catheters were removed 7–10 days after surgery. Conclusion: It was demonstrated that laparoscopic repair of bladder injury, which is a feared complication of LH, can be carried out successfully be gynecologists experienced in endoscopic surgery.