™ Small intraperitoneal perforation can be managed as a extraperitoneal one.
™ If abdominal distension is present and bleeding is under control, stop resection.
™ Insert a 10-mm laparoscopic port midway between umbilicus and the anterior superior iliac spine.
™ Insert a drain through the port.
™ Remove the port and fix the drain.
™ Place a 22-Fr transurethral catheter.
™ After 10 days, check cystogram and removal of the catheter in absence of leakage.
™ If the bleeding is not controllable, perform an inferior laparotomy.
™ Close the bladder defect with Monocryl 3/0 single stitches.
™ Place an intraperitoneal and an extraperito-neal drain.
™ Double drainage of the bladder with transu-rethral and suprapubic catheter.
™ After 7 days, check the cystogram and remove the catheter.
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