Late diagnosis of pseudo-renal failure associated with bladder injury after cesarean section

Nowadays bladder injury during cesarean section is quite uncommon and potentially serious complications are urinary tract infection and formation of vesicovaginal or vesicouterine fistula. There are only few case series of bladder injury at the time of cesarean section in the literature. Most injuries were found intraoperatively, but rarely some may not be recognized during the case. We present a case of late diagnosed bladder perforation at the time of cesarean section and managed by conservative approach. Her clinical picture mimicked renal failure. Conventional cystography failed to demonstrate the bladder perforation, cystoscopy allows recognition of undetected urinary system injury by conventional cystography and intravenous pyelogram. Nonoperative management by concomitant transuretral catheter drainage and ciprofloxacin treatment could be a safe alternative treatment option for even late diagnosed small injuries.