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A large bladder hematoma resulting from infectious hemorrhagic cystitis after pelvic reconstruction with transvaginal mesh: An unusual complication.

Abstract

A large hematoma resulting from hemorrhagic cystitis after uncomplicated pelvic reconstruction surgery with a transvaginal mesh is rare. A 66-year-old female who underwent pelvic reconstruction with transvaginal mesh presented with acute urinary retention and hematuria on postoperative day 10. Leukocytosis, pyuria, and hematuria were noted in the emergency room. After using cystoscopy to irrigate the coagulum, there was no mesh erosion or bladder perforation on inspection. A large bladder hematoma resulting from infectious hemorrhagic cystitis was confirmed, and uropathogenic Escherichia coli was isolated. The clinical condition improved after a 1-week treatment with an indwelling Foley catheter and oral antibiotics. Careful aseptic techniques and antibiotic prophylaxis reduce bacterial contamination only for brief periods of time, and patients may still be at risk for delayed infections. The possible modalities to prevent postoperative urinary tract infection after pelvic reconstruction surgery with transvaginal mesh include shortening the indwelling Foley catheter period and administration of an additional antibiotic during catheter removal. However, the antibiotic policies for pelvic reconstruction with transvaginal mesh demand further cost analyses.

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  • Authors+Show Affiliations

    ,

    Department of Obstetrics and Gynecology, ChiMei Hospital, Tainan City.

    ,

    Department of Obstetrics and Gynecology, Taipei Veterans General Hospital, Taipei. Department of Obstetrics and Gynecology, School of Medicine, National Yang-Ming University, Taipei. Institute of Clinical Medicine, National Yang-Ming University, Taipei.

    Department of Obstetrics and Gynecology, Taipei Veterans General Hospital, Taipei. Department of Obstetrics and Gynecology, School of Medicine, National Yang-Ming University, Taipei. Institute of Clinical Medicine, National Yang-Ming University, Taipei.

    Source

    SAGE open medical case reports 7: 2019 pg 2050313X19846709

    Pub Type(s)

    Case Reports

    Language

    eng

    PubMed ID

    31105946

    Citation

    Shyu, Ing-Luen, et al. "A Large Bladder Hematoma Resulting From Infectious Hemorrhagic Cystitis After Pelvic Reconstruction With Transvaginal Mesh: an Unusual Complication." SAGE Open Medical Case Reports, vol. 7, 2019, p. 2050313X19846709.
    Shyu IL, Wang PH, Huang BS. A large bladder hematoma resulting from infectious hemorrhagic cystitis after pelvic reconstruction with transvaginal mesh: An unusual complication. SAGE Open Med Case Rep. 2019;7:2050313X19846709.
    Shyu, I. L., Wang, P. H., & Huang, B. S. (2019). A large bladder hematoma resulting from infectious hemorrhagic cystitis after pelvic reconstruction with transvaginal mesh: An unusual complication. SAGE Open Medical Case Reports, 7, p. 2050313X19846709. doi:10.1177/2050313X19846709.
    Shyu IL, Wang PH, Huang BS. A Large Bladder Hematoma Resulting From Infectious Hemorrhagic Cystitis After Pelvic Reconstruction With Transvaginal Mesh: an Unusual Complication. SAGE Open Med Case Rep. 2019;7:2050313X19846709. PubMed PMID: 31105946.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - A large bladder hematoma resulting from infectious hemorrhagic cystitis after pelvic reconstruction with transvaginal mesh: An unusual complication. AU - Shyu,Ing-Luen, AU - Wang,Peng-Hui, AU - Huang,Ben-Shian, Y1 - 2019/05/02/ PY - 2018/08/08/received PY - 2019/04/03/accepted PY - 2019/5/21/entrez PY - 2019/5/21/pubmed PY - 2019/5/21/medline KW - Hemorrhagic cystitis KW - mid-urethral sling KW - pelvic reconstruction KW - transvaginal mesh SP - 2050313X19846709 EP - 2050313X19846709 JF - SAGE open medical case reports JO - SAGE Open Med Case Rep VL - 7 N2 - A large hematoma resulting from hemorrhagic cystitis after uncomplicated pelvic reconstruction surgery with a transvaginal mesh is rare. A 66-year-old female who underwent pelvic reconstruction with transvaginal mesh presented with acute urinary retention and hematuria on postoperative day 10. Leukocytosis, pyuria, and hematuria were noted in the emergency room. After using cystoscopy to irrigate the coagulum, there was no mesh erosion or bladder perforation on inspection. A large bladder hematoma resulting from infectious hemorrhagic cystitis was confirmed, and uropathogenic Escherichia coli was isolated. The clinical condition improved after a 1-week treatment with an indwelling Foley catheter and oral antibiotics. Careful aseptic techniques and antibiotic prophylaxis reduce bacterial contamination only for brief periods of time, and patients may still be at risk for delayed infections. The possible modalities to prevent postoperative urinary tract infection after pelvic reconstruction surgery with transvaginal mesh include shortening the indwelling Foley catheter period and administration of an additional antibiotic during catheter removal. However, the antibiotic policies for pelvic reconstruction with transvaginal mesh demand further cost analyses. SN - 2050-313X UR - https://www.unboundmedicine.com/medline/citation/31105946/A_large_bladder_hematoma_resulting_from_infectious_hemorrhagic_cystitis_after_pelvic_reconstruction_with_transvaginal_mesh:_An_unusual_complication L2 - https://www.ncbi.nlm.nih.gov/pmc/articles/pmid/31105946/ DB - PRIME DP - Unbound Medicine ER -