Complete urethrovesical disruption following obstructed labor

Abstract

A 22-years-old lady presented with obstructed labor with a probable preoperative diagnosis of bladder/urethral injury. When a laparotomy was performed there was a complete urethral disruption at the vesicourethral junction with a big anterior forniceal tear in the vagina with intact uterus and cervix. The fetus had pushed itself through the upper vagina and bladder neck into the extraperitoneal space leading to complete urethrovesical disruption as a result of prolonged pressure on the vesicourethral junction against pubic symphysis for which an end to end anastomosis was performed. Although trauma has been mentioned as a cause of such urethral disruption in the literature, no such case has been reported so far following obstructed labor. A brief discussion of various surgical options for such cases is discussed.

Concomitant Vaginal Laceration and Urinary Bladder Injury With Pubic Diastasis: A Case Report on a Rare Complication During Obstructed Labor

“…Because it is such a rare occurrence, it is uncertain whether total urethrovesical disruption happens during obstructed labor. Only two patients (an incidence of 1.9%) of the 102 cases of obstructed labor that were discovered in a retrospective analysis of our patients from 2004 to 2009 had bladder/urethral injuries [6].…”