Bladder haematoma after transvaginal ultrasound-guided oocyte retrieval: a retrospective analysis and comprehensive review of the literature

Bladder hematoma following transvaginal ultrasound-guided oocyte retrieval (TVOR) is rare. We conducted a retrospective analysis of 33,271 patients who underwent TVOR procedures during in vitro fertilization and embryo transfer (IVF-ET) at our centre between January 2015 and June 2023. Additionally, a systematic literature search on bladder haematoma after TVOR was performed. Data on clinical symptoms, diagnostic processes, and treatment interventions for patients with bladder injurie or haematoma were collected and analyzed. We identified six cases (0.018%) of bladder injury following TVOR procedures at our centre. Nine studies reporting 12 cases of bladder haematoma, yielding a pooled incidence of approximately 0.02%. Bladder haematoma occurred at various times after the procedure, ranging from immediate to a maximum of seven days post TVOR. Of the 18 cases examined, four patients received conventional conservative treatment, while 12 patients underwent urinary catheter irrigation and drainage. The most common clinical symptoms included lower abdominal pain, urinary frequency, dysuria, visible haematuria, and urinary retention. Bladder haematoma resulting from bladder injury after TVOR is a rare complication. To reduce the risks associated with such complications, it is crucial to develop protocols that ensure appropriate prophylaxis, monitoring, and treatment for patients undergoing TVOR procedures.