Non-surgical treatment for hematocele in the bladder associated with ascites puncture in a patient with ovarian hyperstimulation syndrome: a case report

Ovarian hyperstimulation syndrome (OHSS) is a well-known complication induced by the application of LH or GnRH analogs in the process of assisted reproduction controlled ovarian stimulation (COS). Ascites puncture is one of the treatments for severe OHSS. In the vast majority of circumstances, transvaginal (TV) ascites puncture under B ultrasound guidance is safe; however, bladder injury is a rare complication that may occur during the puncture process. We presented the case of a 28-year-old woman who presented with hematuria and dysuria following TV puncture for ascites aspiration for OHSS. Ultrasonographic examination revealed a 8.33 × 4.88 cm hematocele in the bladder; it was thought to have been caused by blood clot formation and concurrent urinary retention resulting from the puncture needle-induced bladder injury during TV puncture for ascites aspiration. The patient recovered with conservative treatment. Therefore, it is important to emphasize that avoidance of OHSS is necessary to avoid complications such as bladder damage from treatment of ascites.