Complete eversion and prolapse of bladder following pulling out of a Foley catheter concurrent with uterine prolapse

Abstract

Complete eversion and transurethral prolapse of the urinary bladder is rare. We report a case of complete eversion and prolapse of bladder that occurred due to self pulling out of an indwelling Foley catheter in a 72-year-old woman. She presented with retention of urine concurrent with complete uterine procidentia. An indwelling Foley catheter was given to relieve the retention. The senile lady pulled out the catheter resulting in complete transurethral prolapse with bladder eversion. Under injection Midazolam sedation and with application of xylocain jelly the prolapsed bladder could be reduced manually back through the urethra. Definite corrective surgery was done later for the uterine prolapse.

Case – Management of complete bladder prolapse through the urethra

“…The overall incidence of bladder prolapse through the urethra reported in the literature is limited to case reports in the context of pelvic floor laxity following labor, bladder adenocarcinoma, vesicovaginal fistula, traumatic removal of urethral catheters, or urethral injury from chronic catheterization(s). [1][2][3][4][5][6][7][8][9][10][11][12][13] In our patient's case, an extensive psychiatric history contributed to frequent, prolonged episodes of straining with bowel movements, which likely contributed to both her initial POP and subsequent bladder prolapse. Increased abdominal straining against the pressure effect of her colpocleisis lead to eversion of her bladder through the area of least support after colpocleisis, which was her incompetent bladder neck.…”

Complete bladder eversion through a vesicovaginal fistula

“…There are several proposed predisposing factors that may lead to bladder eversion including multiparity, prolonged labor, and menopause particularly in postmenopausal women with chronic catheterization. 1 , 2 Urethral pathology such as infection, trauma, and urethral sphincteric weakness have also been proposed as predisposing factors leading to bladder eversion. 3 …”

Transurethral urinary bladder eversion and prolapse in a castrated male pet rabbit

“…Multiparous postmenopausal women appear to be at the highest risk (Mastropietro et al, 2002;Kalorin et al, 2009;Kim et al, 2010). Bladder eversion through a vesicovaginal fistula has also been described (Dunn et al, 2004) as a result of bladder adenocarcinoma (Kim et al, 2006), due to self-removal of an indwelling Foley catheter (Acharya and Mishra, 2007), during parturition (Heyns, 1941) and after hemipelvectomy (Lowe et al, 2010).…”