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Transabdominal ultrasound showing a heterogeneous intravesical mass measuring 43.6 mm  31.4 mm in diameter, a suspected blood clot (patient 1).
Source publication
Objective:
Transvaginal oocyte retrieval has become the common method for infertility couples undergoing artificial reproductive technology. Although it was considered to be safe, rare complications including urinary bladder injury were reported.
Case report:
We described two cases of bladder injury with refractory blood clots after oocyte retri...
Context in source publication
Context 1
... a large amount of blood. Laboratory tests indicated a normal hematocrit, and normal leukocyte, platelet, and electrolyte counts. A transabdominal ultrasound showed a complex mass (4.3 Â 3.1 cm) interposed between the anterior bladder wall and posterior blassder wall, and bilateral enlarged cystic ovaries (right: 56 Â 37 mm, left: 74 Â 55 mm) (Fig. 1). A bladder hematoma resulted for oocytes puncture was ...
Similar publications
Bladder blood clots represent an infrequent urinary condition in children. They usually result from hematuria with many underlying causes, such as urinary tract infections and urethral/bladder traumas. Treatment options for clot removal include trans-urethral or suprapubic bladder irrigation and, if unsuccessful, endoscopic management under general...
Citations
... Among endoscopic procedures, authors have described direct Ellik suction [13] or variations of the technique, such as the use of a resectoscope or morcellation device to achieve a progressive reduction of clots and facilitate Ellik suction [4,14,15]. Nevertheless, the bladder distension that occurs during the procedure represents a risk factor for bladder rupture [13]. Other authors, in case of Ellik failure, have proposed continuous mechanical suction [16][17][18]. ...
Bladder blood clots represent an infrequent urinary condition in children. They usually result from hematuria with many underlying causes, such as urinary tract infections and urethral/bladder traumas. Treatment options for clot removal include trans-urethral or suprapubic bladder irrigation and, if unsuccessful, endoscopic management under general anesthesia with a resectoscope. In younger male children, however, the repeated passage of a trans-urethral resectoscope may be challenging and traumatic, due to the small lumen diameter. Eventually, an open surgical approach can be required in many patients. Few anecdotal non-surgical approaches have been proposed for the management of bladder blood clots in children. This review aims to summarize the conservative techniques described in the literature with the instillation of intravesical agents, analyzing the different strategies and their advantages.
... No duplication of the studies or use of the same population of patients was found. After screening the titles and abstracts of publications, hemoperitoneum cases due to adjacent vessel lesions (n = 3) were excluded [15][16][17], as well as those from urinary tract lesions (n = 6) [10, [31][32][33][34][35]. Out of all full-text articles assessed for eligibility, 26 publications and 7 reports were excluded due to unknown bleeding sources causing hemoperitoneum or unclear presentation of patient data [5,6,26,[36][37][38][39]. ...
... We focused on hemoperitoneum as a result of ovarian bleeding with surgery performed for hemostasis, and not from bleeding from other sources, such as injury of blood vessels [15][16][17]39] or from bladder and ureteral injuries [10,[31][32][33][34][35]. ...
Background and Objectives: Severe hemoperitoneum of ovarian bleeding origin is a rare but potentially life-threatening complication of transvaginal oocyte retrieval (TVOR) procedure. The study aimed to present a case series of surgically managed patients from our clinic with hemoperitoneum caused by ovarian bleeding after TVOR, as well as to perform a comprehensive literature review in order to summarize and analyze all published cases with this condition and their management. Materials and Methods: The data of 2939 patients, who underwent TVOR procedures for IVF/ICSI (in vitro fertilization, intracytoplasmic sperm injection) in our clinic between 2010 and 2021 were reviewed. Moreover, a systemic literature search was performed. Main outcome measures from the pooled analysis were incidence and risk factors, type of surgery, intraoperative finding and intervention leading to hemostasis. Results: In our Clinic 4 (0.136%), cases of hemoperitoneum due to ovarian bleeding were surgically managed. Moreover, 39 cases from 18 studies reported in the literature were identified. No risk factors besides lean women with PCOS were identified. In the pooled analysis, the bleeding symptoms appeared in 58.1% of patients within eight hours after TVOR and cumulatively in 81.4% cases during the 24 hours after TVOR. The average time from TVOR to surgery was 27.19 ± 53.25 hours. Hemostasis was mostly established using electrocoagulation, although few cases of ovariectomy were also reported. Embryo transfer at 60% of cases was postponed and embryos cryopreserved. Conclusions: Severe hemoperitoneum due to ovarian bleeding after TVOR is a rare event that should be treated by techniques of minimally invasive surgery whenever possible. Protocols should be developed to enable optimal management strategies for infertility patients. Embryos obtained should be cryopreserved.
... The Ellik Evacuator remains an important tool of all urologists but non-urologists have also utilized its ease of use in gynecologic procedures. (13,14) Ellik himself revered history and one's contributions to it. He wrote on the original concept of a bladder evacuator, lauding the idea fi rst conceived by Bigelow in 1883, and credited Bigelow for the inspiration to develop his own evacuator. ...
Objectives The Ellik Evacuator is a commonly used tool in transurethral endoscopic surgery and a standard of care for the rapid removal from the bladder of resected tumor fragments, prostatic chips, or blood. Little is known, however, about the inventor of the Ellik evacuator, his urologic contributions, and how the evacuator came to be. Methods We contacted surviving descendants of Dr. Milo Ellik, and conducted interviews as part of an oral history project. Original medical equipment and personal belongings, provided by the family of Dr. Ellik, were analysed. Secondary source materials included published urologic articles and unpublished biographic information. Results Milo Ellik was born in Chicago in 1905 but was orphaned and put himself through college. He graduated from the University of Iowa with an MD in 1932 and began residency under Nathan Alcock. Ellik conceived of the evacuator that bears his name as a resident, visiting the glass-blowing facility at the Iowa University Hospital to construct the prototype. He published the results in a 1937 issue of the Journal of Urology but did not obtain a patent which was eventually procured by Bard in 1940. Conclusions Milo Ellik designed a major innovation in transurethral surgery as a resident in urology by constructing the first glass evacuator that bears his name. The Ellik family donated a large quantity of Dr. Ellik’s inventions to the AUA’s Didusch Museum for permanent storage and study.
... However, this method fails in some patients. Other methods of clot evacuation described in the literature include the use of improved flushing devices [2][3][4] or changes in flushing fluid elements. 5,6 However, these methods are complicated and not always effective. ...
Objective
Urinary retention caused by bladder clots can be frustrating because such blood clots are difficult to remove. We established a novel technique in which hydrogen peroxide is applied to evacuate bladder clots.
Methods
In this single-center retrospective study, we evaluated 31 patients with retention of blood clots in the bladder who underwent emergency evacuation using hydrogen peroxide.
Results
The patients comprised 17 men and 14 women with mean age of 61.2 years (range, 42–82 years). Hydrogen peroxide solution and a 20-Fr three-cavity Foley catheter with large-diameter side holes were used for manual bladder irrigation in all patients. The bladder blood clots were successfully removed in 27 patients. The remaining four patients could not tolerate the symptoms of urinary retention and had to resort to surgery.
Conclusion
Hydrogen peroxide solution for manual bladder irrigation can improve the efficiency of bladder blood clot evacuation. This is a simple and effective option for managing bladder clot retention.
To explore the effect of homogenized nursing interventions for bladder irrigation after urological surgery in primary hospitals, and to further analyze the incidence of postoperative complications according to the different nursing methods. The experiment selected 110 patients with urological disorders who underwent bladder irrigation, and the subjects were admitted to the hospital from January 2020 to October 2023. The subjects were chronologically divided into a control group and an experimental group, with the admission time of the control group being between between January 2020 and October 2022. The experimental group was admitted between October 2022 and October 2023. Conventional nursing care and homogenized nursing care were used respectively, and the intervention effect of homogenized nursing care was assessed by comparing the patients’ psychological state indexes, vital characteristic indexes, and the incidence of various postoperative complications under the 2 interventions. None of the indicators were statistically significant before the nursing intervention. In the comparison of nursing satisfaction and clinical comfort, the experimental group’s nursing satisfaction was 94.5% and clinical comfort was 90.9%, which was significantly higher than that of the control group. In the comparison of the incidence of postoperative complications, the incidence of urinary retention in the experimental group was 1.82%, which was significantly lower than that of the control group. In addition, the total incidence of complications in the experimental group was 1.82%, which proved that the homogenized nursing intervention was effective in reducing the complications after urinary bladder irrigation. In multifactorial logistic regression analysis, after homogenized nursing intervention. The relative risks of the 4 complications were 1.836, 1.445, 1.993, and 2.138, respectively, which were significantly lower than those of conventional nursing intervention. In the ROC analysis, the AUC values of the 4 complications were 0.832, 0.731, 0.746, and 0.723, respectively. proving the superiority of homogenized care in preventing postoperative complications. Homogenized nursing intervention can effectively reduce the incidence of postoperative complications in patients with urological postoperative bladder irrigation, improve patients’ symptoms and prognosis, and improve the quality of care and patients’ quality of life.
The standardization of oocyte retrievals as a simple outpatient procedure has promoted safety and efficacy of in vitro fertilization. Early attempts of oocyte retrieval were via laparoscopy. However, the technical limitations of laparoscopic oocyte retrieval, specifically the need for general anesthesia, resulted in development of transabdominal and transvaginal techniques, which could be performed with local anesthesia or minimal sedation. Further improvements in ultrasound technology, anesthetics, antibiotics, and retrieval needles have simplified the technique for modern-day transvaginal ultrasound-guided oocyte retrievals. While most oocyte retrievals are performed without event, occasional minor and major complications may occur, which can be managed in the outpatient setting. Rare life-threatening complications can require inpatient treatment or immediate surgical treatment.KeywordsOocyte retrievalEgg retrievalOocyte pick-upIVFComplicationsManagement
