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#1067 Bladder injury in lymph node stratification surgery of a stage II endometrial cancer
  1. CRISTINABenito Pedregosa,
  2. NÚRIANieto Fernandez,
  3. BRUNAFurriols Raulí and
  4. PAU Carabias Meseguer
  1. HOSPITAL MATARÓ, Barcelona, Spain


Introduction/Background Bladder injury is widely described in laparoscopic gynaecology surgeries such as hysterectomies or lymphadenectomies, especially if the patient needs to receive multiple surgeries. Nevertheless, usually it can be easily repaired and urinary functions can be quickly recovered.

Results A 69-year-old woman attends her gynaecologist for pink vaginal discharge and a thigh endometrium is seen in the vaginal ultrasound. An endometrial Cornier sampling is made and reveals endometrioid adenocarcinoma with mucinous differentiation, histological grade I. MRI is performed and informs of a 1b endometrial neoplasia. A hysterectomy with double adnexectomy, bilateral sentinel lymph node biopsy, and a left pelvic lymphadenectomy is undertaken. The histological examination reveals endometrioid adenocarcinoma with extensive mucinous differentiation (>50%) and focal squamous differentiation, grade 2, with >50% myometrial invasion but no serous infiltration, affection of the low uterine segment and invasion of de cervical stroma, with negative lymph nodes. On the tumour board, it is decided to perform an additional pelvic and paraaortic lymphadenectomy. On a second surgery, doctors find several intestinal adhesions and a widely fibrosed peritoneal tissue. When getting into the left paravesical space, after identification of both the external iliac artery and vein, as the lymph node sampling has started, a lesion on the left anterolateral bladder wall is suddenly discovered. The surgeons perform a Vicryl 3/0 continuous suture and call the urologist. A cystoscopy is carried out, with catheterisation of the left ureter and a check of its integrity. After a fast look at the right paravesical space, which is found to be also largely fibrosed, it is decided to end up the surgery. The patient needs an indwelling urinary catheter for 14 days, without other further urinary complications. Finally, she receives adjuvant pelvic radiotherapy and posterior radiotherapy on vaginal cupula.

Conclusion Very good outcomes can be achieved if early intervention is performed in bladder injuries.

Disclosures The author or authors declare that they have no conflict of interest with respect to the author or publication of this article.

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