A case of bladder flap hematoma presenting with hematuria

Abstract

Objectives: Patients with bladder flap hematoma usually present with a mass lesion, signs of hypovolemia and/or infection. We herein introduce a patient that presented with an extraordinary sign of bladder flap hematoma. Case Presentation: A woman with term pregnancy presented to our hospital in labor. She underwent cesarean delivery due to persistent late decelerations. Cesarean delivery was performed with the traditional cesarean section method. On the first postoperative hour, the patient developed postpartum hemorrhage due to uterine atony. She had severe anemia and tachycardia. Transvaginal ultrasonography revealed the presence of 86 × 77 mm solid mass interposed between lower uterine segment and bladder. Slow-onset hematuria was noticed in the previously clear urinary discharge. The patient was treated conservatively. Conclusion: Hematuria may be a sign of bladder flap hematoma. Though no exact and standardized protocols exist for the management, conservative approach is one of the treatment modalities and may be offered for eligible patients.