Anatomy and Surgical Approach to Transurethral Bladder Eversion

INTRODUCTION: Transurethral bladder eversion is a rare occurrence that can present alongside pelvic organ prolapse. The literature on the surgical management of bladder eversion is limited. In this video, we review a case presentation, describe the pertinent anatomy, and outline a surgical approach to correcting transurethral bladder eversion. OBJECTIVE: Our objectives are to review the clinical presentation of a patient with complete transurethral bladder eversion, to understand anatomic considerations related to this condition, and to describe a vaginal approach to surgical correction of transurethral bladder eversion with concurrent procidentia. METHODS: Informed consent was obtained from the patient prior to video recording and image collection. The selected media were edited and arranged to create an educational narrative film, with particular emphasis on key anatomical landmarks. Care was taken to protect the patient's privacy and confidentiality throughout the video creation process. This video is designed for the education of gynecologic surgeons, fellows, and residents. RESULTS: A vaginal surgical approach to transurethral bladder eversion repair is less invasive, especially for patients with multiple medical comorbidities. Primary bladder neck closure and suprapubic tube placement with LeFort colpocleisis is a viable route of surgical repair. CONCLUSIONS: Transurethral bladder eversion is a rare condition and understanding the anatomy is crucial to surgical repair. Careful consideration of surgical approach and shared decision-making are paramount to management.