Laparoscopic Management of Post-cesarean Uterovesical Abscess: A New Approach to an Old Problem

Excerpt

A uterovesical abscess, also called a bladder flap hematoma, is a rare complication of cesarean delivery. It refers to an enclosed collection between the lower uterine segment and bladder [1]. These cases present any time from day 2 of cesarean to several weeks postpartum with fever unresponsive to antibiotics, anemia, suprapubic pain, and a visible pelvic collection between the uterus and bladder on ultrasound, CT, or MRI. The various described methods of treating such patients include conservative medical management, percutaneous or transvaginal drainage, laparoscopy, or, traditionally, for significant collections, laparotomy. We describe a case of bladder flap hematoma whom we treated by laparoscopy and conclude that minimally invasive techniques applied to obstetric practice may significantly reduce maternal and neonatal morbidity. Institute review board approval and informed patient consent were taken for this case. …