PMC6501478_01
Contrast-enhanced CT scan of abdomen: (a) preoperative image study, where the yellow arrow indicates prolapsed uterus on coronal section; (b) image study at ER, where the yellow arrow indicates bladder hematoma s/p catheterization on coronal section; (c) image study at ER, where the yellow arrow indicates bladder hematoma s/p catheterization on transverse section; and (d) postoperative follow-up image study 3 months after operation, where the yellow arrow indicates non-prolapsed uterus on coronal section.
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A 66-year-old female, gravida 4 para 4, presented to the outpatient department with both total uterine prolapse and one right femoral hernia for more than 5 years (Figure 1(a)). A distended bladder with a complex inner pattern on the trans-abdominal sonogram suggested hematoma formation, and the lower abdominal computed tomography (CT) scan revealed a large hematoma within the urinary bladder (Figure 1(b) and (c)). During the 3-month follow-up period, there was no recurrent POP or USI or voiding difficulty (Figure 1(d)).
Procedures of cystoscopy: (a) procedure during drawing coagulum and (b) there was hyperemia of bladder mucosa without submucosal hemorrhage or gross hematuria on cystoscopy.
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During cystoscopy, a large amount of coagulum was drawn out, while no active bleeding or traumatic lesion was noted (Figure 2(a) and (b)).