Bladder repair following iatrogenic cystotomy in irradiated small capacity bladders

During laparotomy in a previously irradiated and operated pelvis, incidental cystotomies can occur and a tension-free, watertight, two- or three-layer closure of the bladder may be impossible. We herein report two cases of iatrogenic defects of the bladders in post-irradiated pelvises and compare th...

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Bibliographic Details
Published in:Singapore medical journal 2015-03, Vol.56 (3), p.e49-e52
Main Authors: Chee, J Y, Durai, P, Wu, F M, Tiong, H Y
Format: Article
Language:English
Subjects:
Aged
Animals
Case Report
Cattle
Female
Humans
Iatrogenic Disease
Ileum - diagnostic imaging
Ileum - surgery
Intestines - diagnostic imaging
Intestines - surgery
Laparotomy - methods
Male
Middle Aged
Pericardium - surgery
Reconstructive Surgical Procedures
Surgical Flaps
Tomography, X-Ray Computed
Urinary Bladder - diagnostic imaging
Urinary Bladder - injuries
Urinary Bladder - surgery
Urologic Surgical Procedures
Uterine Cervical Neoplasms - complications
Uterine Cervical Neoplasms - radiotherapy
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Summary:During laparotomy in a previously irradiated and operated pelvis, incidental cystotomies can occur and a tension-free, watertight, two- or three-layer closure of the bladder may be impossible. We herein report two cases of iatrogenic defects of the bladders in post-irradiated pelvises and compare the two different methods of bladder repair employed - an ileal augmentation segment used in the first case and bovine pericardial graft used in the second. Successful closures of the bladder defects were achieved in both cases. Native irradiated bowel and bovine pericardium can be useful substitutes in situations involving bladder defects in a previously irradiated pelvis. The advantages and disadvantages of the two approaches are also herein discussed.
ISSN:0037-5675
DOI:10.11622/smedj.2015052