Postoperative extraperitoneal bladder injury after metal pelvic osteosynthesis for pelvic injury

Bladder injury is one of the recognized entities of the genitourinary organ system trauma. The causes are numerous, including road traffic crashes, falls from heights, gunshot injuries, and iatrogenic causes, among others. In some cases, the diagnosis may be difficult to make or missed, resulting in severe morbidity. Postoperative implant-associated bladder injury is a rare and unfamiliar etiology in our setting. This article discusses the case of a 60-year-old farmer who sustained polytrauma in a road traffic crash, including pelvic fracture and urethral distraction injury, among others. He had a pelvic implant during the initial surgical intervention as part of resuscitation or damage control surgery. However, urine started to leak from his suprapubic wound a few days after operation. This condition was persistent despite continuous bladder drainage with an indwelling urethral catheter. He subsequently had bladder re-exploration, which confirmed an anterior bladder wall perforation secondary to the dislodged pelvic implant. Bladder injury due to pelvic implant is rare, but possible. Bladder exploration is warranted and rewarding in patients with suspicion of persistent vesicocutaneous fistula following pelvic implant surgery.