Iatrogenic bladder injuries from IVIF egg harvesting are uncommon. However, they can result in significant bleeding requiring operative management.

We describe a case of a 40 year old female who presented to our hospital with clot retention following IVIF egg harvesting. Patient was anaemic with a haemoglobin of 78. CT intravenous pyelogram demonstrated a large bladder haematoma.

Our patient was transfused 2 bags of packed red blood cells. A 22 Fr 3 way catheter was inserted, and manual washouts and continuous bladder irrigation was implemented. However, due to ongoing bleeding the decision was made to take the patient to theatre. We performed a rigid cystoscopy, clot evacuation, cystodiathermy and bilateral retrograde pyelogram procedure. A large 100 cc clot was evacuated. There was active bleeding at the bladder neck which was diathermied. There were multiple puncture marks within the bladder. Bilateral retrograde pyelograms demonstrated no contrast extravasation. The patient made a good recovery and was discharged home on day 2, after ceasing bladder irrigation and passing their trial of void.

Iatrogenic bladder injuries from IVIF egg retrieval can result in significant bleeding needing blood transfusions and operative management. We describe a successful method of rigid cystoscopy, clot evacuation, cystodiathermy and bilateral retrograde pyelogram procedure in managing this IVIF complication.