Here we report a case with fever, abdominal pain, frequent urination and urinary incontinence after vesicolysis, for bladder hematoma after transvaginal ultrasound-guided oocyte retrieval, that was successfully treated with Kampo medicine based on daily changing sho for acute disease.
A 44 year-old woman underwent transvaginal ultrasound-guided oocyte retrieval under venous anesthesia in the morning, in order to perform in vitro fertilization, and got home around noon. She had right lower quadrant abdominal pain, frequent urination, hemoptysis, urinary incontinence, fever and chill in that evening. Emergency room ultrasonography revealed a 45 mm size bladder hematoma. She was admitted and the vesicolysis was performed. Antibiotics and hemostatics were administered, and were followed by self-sustaining flow back into the bladder. Although she became afebrile on day 3, her right lower quadrant abdominal pain remained and fever returned on day 5. Daiobotanpito was prescribed because of the right lower quadrant abdominal pain, frequent urination, urinary incontinence, constipation and a floating pulse. Additionally, goreisan was prescribed because of her tooth mark and leg edema. On day 6, her abdominal pain had largely disappeared, and her frequent urination and urinary incontinence were also improved. However, perspiration with fever and soft stools then appeared. Keishito was prescribed because of the perspiration, a weak pulse and weak abdominal strength. Additionally choreito was prescribed for the frequent urination and urinary incontinence. She started sweating continuously with no fever. The frequent urination and urinary incontinence then also disappeared, and she was discharged on day 7.