Successful Repair Management for Urinary Bladder Perforation During Myomectomy on Cervical Myoma on Patients with Previous Cesarean Section: A Challenging Case Report

The 20-25% incidence of uterine myoma often experienced by women in childbearing age and 2% these myomas attach grow the cervical area. chief complain myom are lumps lower abdomen that getting bigger pressing on urinary bladder cause difficulty urinating accompanied bloody urine, although amount menstrual blood is still within reasonable limits. Like myomas, not fused with myometrial lining but covered thin connective tissue surface.The procedure based ACOG (American College Obstetrics Gynecology) hysterectomy if patient no longer wants to get pregnant, or myomectomy have children. Both actions a very high risk which vascularization pelvic area will be complex, pressure injuring mucosa when setting aside segment uterus there injury. We present 38-year-old woman 30x 26 x 22 cm giant secondary infertility was treated challenging laparotomi colaboration urologist preserve fertility. There tear upper part elongated irregular edges measuring 12 5 after enucleation myoma. repaired immediately complications form vesico-vaginal fistulas vesico-cervical postoperatively.