Spontaneous bladder rupture attributable to a radical hysterectomy-associated neurogenic bladder in patients with cervical cancer: A case report and literature review

Spontaneous bladder rupture (SBR) is an extremely rare urological emergency. Herein we report a rare case of SBR in a postoperative cervical cancer patient, which was attributable to bladder distension due to a radical hysterectomy-associated neurogenic bladder. A 74-year-old nulliparous Japanese pa...

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Bibliographic Details
Published in:International journal of surgery case reports 2023-02, Vol.103, p.107879, Article 107879
Main Authors: Hayashida, Harue, Mabuchi, Seiji, Kawamura, Norihiko, Matsuzaki, Shinya, Hisa, Tsuyoshi, Kamiura, Shoji
Format: Article
Language:English
Subjects:
Case Report
Cervical cancer
Neurogenic bladder
Radical hysterectomy
Spontaneous bladder rupture
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Summary:Spontaneous bladder rupture (SBR) is an extremely rare urological emergency. Herein we report a rare case of SBR in a postoperative cervical cancer patient, which was attributable to bladder distension due to a radical hysterectomy-associated neurogenic bladder. A 74-year-old nulliparous Japanese patient with cervical cancer (pT1b3N0M0) presented with acute abdominal pain nine days after a radical hysterectomy. The pretreatment workup included plain computed tomography (CT) revealed the presence of ascites in the absence of gastrointestinal perforation. The patient was initially diagnosed with generalized bacterial peritonitis and treated with antibiotics. Urine outflow was noted 5 days later from the vaginal stump. Subsequent contrast-enhanced CT demonstrated a bladder wall defect with presence of contrast medium in the abdominal cavity. The patient was diagnosed with SBR and was conservatively treated with antibiotics and prolonged catheterization (4 weeks); these measures showed no signs of therapeutic efficacy. The patient was subsequently treated surgically with an ileal conduit urinary diversion. The patient is currently free of disease. A literature review revealed that a history of pelvic radiotherapy is the main predisposing factor for SBR in women with cervical cancer. Our case serves to alert physicians that SBR should be considered a differential diagnosis in postoperative cervical cancer patients without a history of pelvic radiotherapy who experience generalized peritonitis symptoms or present as an acute abdomen. SBR can develop in cervical cancer patients without a history of radiotherapy. This differential diagnosis should be considered in patients with a radical hysterectomy-associated neurogenic bladder. •Spontaneous bladder rupture (SBR) is an extremely rare urological emergency.•Most SBR in cervical cancer patients were the complications of pelvic radiotherapy.•We report a SBR case caused by radical hysterectomy-associated neurogenic bladder.•SBR can develop in cervical cancer patients without a history of radiotherapy.
ISSN:2210-2612
2210-2612
DOI:10.1016/j.ijscr.2023.107879