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Atypical use of urethrotome for division of suture in a post partum patient: a case report
  1. CL Khoo,
  2. S Attarbashi,
  3. J Davies,
  4. T Ayakannu,
  5. M Dauleh
  1. Royal Albert Edward Infirmary, Wigan, UK

Abstract

The use of hydrostatic balloons for the management of severe post partum haemorrhage is becoming increasingly popular.

Insertion of an intrauterine hydrostatic balloon through the Caesarean section wound intraoperatively has been described in the past, with inflation of the balloon after wound closure.

The authors report a case of a suture inadvertently encircling the diameter of a Rusch balloon catheter during uterine closure, with subsequent inability to remove the catheter 24 h later.

A hysteroscopy was performed for this unusual indication, which identified the culprit suture. The authors were unable to cut the suture using conventional equipment and the authors describe the atypical use of an urethrotome for division of the aberrant suture.

In conclusion, the use of hysteroscopy to diagnose the problem, even fewer than 48 h after a Caesarean section and improvisation in the use of highly specialised equipment is sometimes helpful in solving seemingly intractable problems and avoided the need to resort to an open technique to remove the suture.

To the best of our knowledge, this is the first reported case using an urethrotome to divide a suture in a postpartum patient.

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