Iatrogenic Bladder Rupture After Insertion of a Urinary Catheter in a Patient With Bladder Cancer: A Case Report.

Abstract

Background: Iatrogenic bladder rupture is a rare but potentially life-threatening complication. Bladder rupture resulting from the insertion of a urinary catheter is exceedingly uncommon. Here, we report a case of bladder rupture after urinary catheter insertion in a patient with bladder cancer.

Case presentation: An 80-year-old woman presented to the emergency department with fever, flank pain, and difficulty urinating. Her medical history included bladder cancer and neurogenic bladder. A urinary catheter had been placed owing to recent worsening of bladder function and had been maintained for 10 days. It was removed at an outpatient urology clinic the day before her emergency department visit to prevent a urinary tract infection. However, due to urinary retention, the urinary catheter was reinserted in the emergency department. After insertion, she complained of acute abdominal pain. Computed tomography revealed an intraperitoneal bladder rupture, with the urinary catheter positioned extraluminally through the bladder dome. The catheter was repositioned under ultrasound guidance, and conservative management with broad-spectrum antibiotics was initiated. The patient recovered well and was discharged without complications after 3 weeks.

Discussion: Urinary catheterization in patients at high risk of bladder rupture should be performed with careful technique, and the use of ultrasound guidance may be considered to minimize the risk of injury and ensure proper catheter placement.