[Urinary complications during laparoscopy: a urachal diverticula injury]. / Complications urinaires de la coelioscopie: à propos d'une plaie d'un diverticule ouraquien.

The authors report a bladder injury during laparoscopic procedure. A laparotomy is performed immediately and shows an urachal anomaly with the bladder reaching the umbilic. One of the accessory trocars perforates the bladder in its unusual position. Surgical repair is made and the patient discharged without sequelae 12 days later. Rate of bladder injury increases with development of advanced laparoscopy as Burch and hysterectomy. Careful drainage with folley catheter during all laparoscopic procedures present greater than morbidity. Previous laparotomy may change the usual position of the bladder. Care must be taken in case of wall anomalies as in our observation. Per-operative suspicion of bladder injury (hematuria, presence of gas in the urinary catheter collection bag) can be proved with the injection of methylene blue in the folley catheter. Laparoscopic repair is possible for an experienced surgeon, associated with 10 days continuous urinary drainage and quinolone antibiotherapy. Morbidity of unknown bladder injury is great with some death-case reports. All diagnosis technique possible must be used to light these clinical situations, urinary peritonitis symptomatology is often non specific.

[Prune Belly syndrome. A case of recurrence]. / Syndrome de Prune Belly. A propos d'un cas de récurrence.

Prune belly syndrome is rare. It involves a combination of muscular hypoplasia of the abdominal wall, marked dilatation of the bladder and ureters and, in its most severe form, bilateral testicular ectopia. Fetuses of both sexes may be affected, with a marked predominance of males. The prognosis is poor, with a mortality rate in excess of 50%, due essentially to renal and respiratory complications. The authors evaluate the prognosis of Prune Belly syndrome with regard to a case of recurrence and suggest a modern approach to its management.