Infrapubic Foley catheter balloon tamponade for retropubic venous haemorrhage during radical cystoprostatectomy and urethrectomy

Radical cystoprostatectomy with pelvic lymph node dissection, urethrectomy and ileal conduit formation is a complex surgical procedure with significant morbidity. One of the important aspects of this procedure is obtaining control of the dorsal venous complex (DVC) and achieving haemostasis. A male patient in his 70s with high-grade urothelial carcinoma had moderate bleeding from the DVC during this procedure. Conventional methods failed to control the bleeding, prompting an additional infrapubic incision for better access. A Foley catheter was inserted into the retropubic space and balloon inflated to achieve haemostasis, allowing completion of the procedure and closure. Postoperatively, the Foley catheter remained on traction for 2 days and was removed on day 5 after surgery. This case report highlights the novel use of an infrapubic urinary catheter balloon tamponade for management of persistent retropubic bleeding during this procedure and underscores the need for further studies to evaluate its safety and effectiveness in managing intraoperative bleeding.