Best choice to your bladder

Best choice to your bladder

Best choice to your bladder

Bladder injury is very serious complication of lap assisted vaginal hysterectomy,especially in incontinence people. Urine drainage bag can help people reduce the gas and urine pressure to your bladder.

Type of operative procedure laparoscopic assisted vaginal hysterectomy laparoscopic assisted vaginal hysterectomy performed using three port sign symptom of bladder injury During surgery balloon like distention of bladder catheter bag with gas or co2 discharge of clear fluid into the operative field haematuria management of bladder injury during surgery cause of bladder injury primary and secondary trocar perforation .hasson technique for open laparoscopy may reduce three type of injury .2nd and 3rd trocar should be inserted under vision previous surgery increase the risk of in advertent cystostomy by placing the bladder on traction close to umbilicus or because adhesion place it in the path of secondary trocar .in addition previous surgery can result in adhesion formation which obliterator the position of the bladder adhesion can for in the area of cervico-vaginal junction as result of previous cesarean section and extend the attachment of the bladder beyond lower uterine segment .other cause of mechanical injury .sharp scissors or blunt dissection of adhesion or seen near the dame of bladder may be adhesion from previous infection surgery relating to the bowel ,appendix or peritonitis .

Thermal injury

Excessive coagulation may be responsible for thermal bladder necrosis .use of unipolar cautry in proximity to the bladder surface should be avoided. Vesico vaginal fistula can occur following operative laparoscopy .it uterus is detached from bladder using unipolar or bipolar cautry excessive thermal coagulation may be responsible for thermal bladder necrosis .thermal necrosis may be some apparent only in post operative period when a vesico-vaginal fistula occurs fistula can also occur if bladder is taken up when vagina is sutured from below .

To minimize bladder injury in patient with previous cesarean section urine drainage bag should be used to enter the anterior cul-de-sac during laparoscopic interfacial hysterectomy lateral window of vesico vaginal space aware opened first. Management of trocar veress needle injury .may be managed with folly catheter for one week with no subsequent complication .injury to bladder during laparoscopy assisted vaginal hysterectomy is small and loaded some distance away from trigone of bladder it can be retired laparoscopically two layer closer with delayed absorbable suture material and check that the bladder is water tight by injection 300 ml of methylene blue via the bladder catheter.

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