Intrauterine Foley urethral catheter for postmyomectomy uterine bleeding

Submucous uterine fibroids are most often removed by hysteroscopic procedures in developed countries but abdominal myomectomy remains common in developing countries. The removal of submucous fibroids during abdominal myomectomy often leads to the inadvertent opening of the endometrial cavity. Postoperative uterine bleeding is a known complication of such breaches in the endometrium even after careful repair. Two cases of severe postmyomectomy uterine bleeding were managed. The first patient was referred from a private hospital with a 16 days history of persistent vaginal bleeding which started 24 h following myomectomy for submucous uterine fibroids. The endometrial cavity had been inadvertently opened but repaired during the procedure. The patient was first given 6 units of blood. Then a 16F Foley urethral catheter was inserted in the uterine cavity and the balloon filled with 30 mL of sterile fluid was left in place. Finally the patient was given prophylactic antibiotics. The vaginal bleeding was reduced to trickles within 12 h of catheter insertion and completely stopped within 24 h. The catheter was removed 48 h after insertion. The patient has resumed normal menstruation. (excerpt)