This is a real-world medical entrance exam question, please give the true answer based on the question and selection. Topic name: All India exam, Subject name: Microbiology
In an immediate postoperative hysterectomy, a patient develops leakage of urine. What is the most likely cause? 
Select and explain. 
A. Urethral injury, B. Bladder injury, C. Overflow incontinence, D. Stress urinary incontinence
B: Bladder injury
Answer: B: Bladder injury 
Explanation: Immediate postoperative leakage of urine develops due to drainage of the peritoneal collection of urine. Both bladder and ureteral defects can cause leakage of urine into the peritoneal cavity. Bladder injury is more common than ureteral injury with the incidence of 1%. The other presentation may be abdominal pain and ascites. Overflow incontinence is because of detrusor underactivity and is usually not a complication of hysterectomy Stress urinary incontinence is because of urethral hypermobility or intrinsic sphincter deficiency, the causes are usually insufficient to suppo from pelvic floor muscles and neuromuscular damage and hence is uncommon with hysterectomy