In immediate postoperative hysterectomy a patient develops leakage of urine. What is the most likely cause
Correct Answer: Bladder injury
Description: Immediate postoperative leakage of urine develops due to drainage of peritoneal collection of urine. Both bladder and ureteral defects can cause leakage of urine into the peritoneal cavity. Bladder injury is more common than ureteral injury with incidence of 1%. The other presentation may be abdominal pain and ascites.
Overflow incontinence is because of detrusor underactivity and is usually not a complication of hysterectomy
Stress urinary incontinence is because of urethral hypermobility or intrinsic sphincter deficiency, the causes are usually insufficient support from pelvic floor muscles and neuromuscular damage and hence is uncommon with hysterectomy
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