Complete eversion of the urinary bladder: presentation, review, and algorithm for management.

Abstract

Complete eversion of the urinary bladder is a rare problem that presents a serious management challenge. Currently no standard treatment recommendations exist for management. We describe our experience with bladder eversion and present an algorithm for treatment. An elderly, multiparous woman presented with complete bladder eversion after partial colpocleisis. Her bladder was reduced by a combined suprapubic and perineal approach with cystopexy to the anterior abdominal wall. Multiparous postmenopausal women appear to be at highest risk for complete bladder eversion. External transurethral reduction is sometimes successful, but most cases require laparotomy.