Iatrogenic bladder neck rupture due to traumatic urethral catheterization: A case report

BACKGROUND In this article,we present a case of iatrogenic bladder neck rupture due to catheter insertion in a 94-year-old comorbid male patient.CASE SUMMARY The patient,who had a urethral catheter inserted in the palliative service 3 d ago,was consulted because the catheter did not work.Because the fluid given to the bladder could not be recovered,computed tomography was performed,which revealed that the catheter had passed the bladder neck first into the retrovesical area then into the intraabdominal area.The appearance of the anterior urethra and verumontanum was normal at cystoscopy.However,extremely severe stenosis of the bladder neck,and perforated posterior wall of the urethral segment between the prostatic urethra and the bladder neck were observed.Internal urethrotomy was applied to the bladder neck with a urethrotome.An urethral catheter was sent over the guide wire into the bladder.The patient was followed in the palliative care service and the catheter was removed 7 d later.No extravasation was observed in the control urethrography.CONCLUSION Although catheter insertion is a simple and frequently performed procedure in hospitalized patients,it is necessary to avoid unnecessary extra-indication catheter insertion.

Spontaneous Rupture of Urinary Bladder (SRUB): An Exceptional Presentation

Background: Spontaneous rupture of urinary bladder (SRUB) without trauma is an extremely rare pathology. The incidence is estimated to about 1/126,000. It is difficult to diagnose. Aim: To present an exceptional case report and emphasize on the difficulty of diagnosis. Case Presentation: We report the case of a 63-year-old man. The initial diagnosis of SRUB was obscured by a urinary retention. The pelvic ultrasound finally led to the diagnosis. We will pay particular attention to the circumstances of the diagnosis and the therapeutic measures applied. Conclusion: SRUB is exceptional and misdiagnosis is usual. Management is most of the time surgical.

Recurrent ascites due to spontaneous intraperitoneal bladder rupture after pelvic radiation therapy for cervical cancer

Radiation cystitis is one of the major complications following radiotherapy for cervical cancer. However, spontaneous intraperitoneal bladder rupture as a result of radiation cystitis following radiotherapy for cervical cancer is extremely rare. Case presentation: We report a 52-year-old patient who received radiation therapy for cervical cancer 15 years prior to presentation. Eight years prior to presentation, she developed recurrent abdominal distension, oliguria, and ascites. Following ascites drainage and supportive treatment, all symptoms were relieved. However, all symptoms subsequently recurred every few months. The patient underwent exploratory laparotomy twice. The first exploratory laparotomy in July 2015 found no specific abnormalities. The second exploratory laparotomy in November 2016 found an intraperitoneal bladder rupture, and the patient underwent surgical repair. The ascites subsequently resolved. Conclusion: The occurrence of spontaneous intraperitoneal bladder rupture after radiation therapy for cervical cancer is rare. The prognosis is good when diagnosis and treatment are prompt.

Analysis of 3 cases of bladder explosion in transurethral plasma prostatectomy

Objective:To investigate the causes of bladder explosion during transurethral plasmakinetic resection of prostate and to explore effective measures to reduce the risk of bladder explosion.Methods:The treatment process of bladder rupture(2cases)and bladder muscle layer laceration(1case)during transurethral plasmakinetic resection of prostate were retrospectively analyzed.Results:Two cases with intra-peritoneal rupture were cured by open surgery,and 1case with bladder muscle layer laceration was cured by conservative treatment.The main cause of bladder explosion is that:the flammable gas produced during the resection of prostate tissue mixed with the gas from the outside into the bladder to a certain proportion,in the action of electric spark,causing gas explosion.Conclusions:Using dorsal elevated position,shortening operative time,and reducing gas entering the bladder are three key points to prevent bladder explosion.