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CASE REPORT
Year : 2007  |  Volume : 23  |  Issue : 4  |  Page : 474-475
 

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


1 Department of Surgery, Ispat General Hospital, Rourkela, Orissa - 769 005, India
2 Department of Obstetrics and Gynecology, Ispat General Hospital, Rourkela, Orissa - 769 005, India

Correspondence Address:
Amulya M Acharya
Department of Surgery, Ispat General Hospital, Rourkela, Orissa - 769 005
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0970-1591.36727

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   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.


Keywords: Bladder, eversion, prolapse


How to cite this article:
Acharya AM, Mishra D R. Complete eversion and prolapse of bladder following pulling out of a Foley catheter concurrent with uterine prolapse. Indian J Urol 2007;23:474-5

How to cite this URL:
Acharya AM, Mishra D R. Complete eversion and prolapse of bladder following pulling out of a Foley catheter concurrent with uterine prolapse. Indian J Urol [serial online] 2007 [cited 2018 Nov 18];23:474-5. Available from: http://www.indianjurol.com/text.asp?2007/23/4/474/36727



   Introduction Top


Complete eversion and transurethral prolapse of urinary bladder is rare. Few cases have been reported this occurring in elderly woman, concurrent with uterovaginal prolapse, following labor and eversion through vesicovaginal fistulas. We report a rare case of complete eversion and prolapse of bladder through the urethra following pulling out of an indwelling Foley catheter given to an elderly women admitted for retention of urine concurrent with uterovaginal prolapse.


   Case Report Top


A 72-year-old woman was admitted for retention of urine. She was a multiparous elderly lady and examination revealed longstanding complete uterine prolapse. An indwelling Foley catheter was given to relieve the retention. Next day, the senile lady pulled out the catheter herself resulting in complete eversion and prolapse of the bladder. Physical examination revealed a red edematous, slimy, pyriform mass 6 cm in diameter sitting over the completely prolapsed uterus [Figure - 1]. The mass was separate from the uterine mass and had an orifice posteriorly placed [Figure - 2]. On introducing a catheter through the orifice about 10 ml urine was obtained. A diagnosis of complete eversion and prolapse of bladder was made.

Patient was sedated with injection Midazolam and after applying a liberal amount of xylocain jelly, the everted bladder was reduced back through the urethra [Figure - 3]. External urethral meatus showed a small tear, she was catheterized again. A definitive corrective surgery for the uterine prolapse was carried out later.


   Discussion Top


Complete transurethral eversion and prolapse of bladder is rare and the pathogenesis is not much known. Some earlier reports mention complete transurethral inversion of bladder occurring during labor. [1] Few reported as complication of vesicovaginal fistula. [2],[3] Senility, obesity, multiple labor could be possible causes of complete eversion of bladder. [4] Uterovaginal prolapse with laxity of pelvic floor are seen associated with this condition. [5] Delayed management may lead to serious conditions like acute renal failure. [3] In one case concurrent adenocarcinma in the thickened wall of the everted urinary bladder could be demonstrated by MRI. [6]

In our case, traumatic pulling out of the Foley catheter precipitated the complete eversion and prolapse of the urinary bladder in the previous weak and lax pelvic floor concurrent with the existing uterine procidentia.

 
   References Top

1.Armon PJ. Complete transurethral inversion of the bladder in labour: A case report. J Obstet Gynaecol Br Commonw 1974;81:822-4.  Back to cited text no. 1  [PUBMED]  
2.Banerjee S, Fusey SS. Vesicovaginal fistula with bladder eversion: A rare complication of third degree cervical descent. J Obstet Gynaecol Can 2006;28:160-1.  Back to cited text no. 2  [PUBMED]  
3.Dunn JS, Bent AE, Tutrone RF, Ellerkmann RM. Acute renal failure caused by complete bladder eversion through vesicovaginal fistula. Int Urogynecol J Pelvic Floor Dysfunct 2004;15:49-50.  Back to cited text no. 3  [PUBMED]  [FULLTEXT]
4.Underhill TR, Altaffer LF 3 rd . Complete eversion and prolapse of bladder. Urology 1983;22:622-3.  Back to cited text no. 4    
5.Mastropietro MA, Clark MH, Hale DS. Transurethral bladder eversion concurrent with uterovaginal prolapse. Obstet Gynecol 2002;99:921-5.  Back to cited text no. 5  [PUBMED]  [FULLTEXT]
6.Kim YH, Sung DJ, Cho SB, Chung KB, Cha SH, Park HS, et al . Complete eversion and prolapse of bladder concurrent with primary adenocarcinoma. Br J Radiol 2006;79:e8-11.  Back to cited text no. 6  [PUBMED]  [FULLTEXT]


    Figures

  [Figure - 1], [Figure - 2], [Figure - 3]

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    Abstract
    Introduction
    Case Report
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