Rupture of ectopic pregnancy implanted in the bladder
Jose Carlos Truzzi1, Hudson Lima, Eduardo Capatti Nunes
1Division of Urology, University of Santo Amaro, São Paulo, Brazil. jctruzzi@hotmail.com
Summary
A rare case of ectopic pregnancy implanted in the bladder wall was treated with methotrexate. Despite initial reduction in human chorionic gonadotropin (hCG), the pregnancy ruptured, requiring emergency surgery.
Area of Science:
- Reproductive medicine
- Gynecologic surgery
- Obstetrics
Background:
- Ectopic pregnancy, a life-threatening condition, typically occurs in the fallopian tubes.
- Intravesical or bladder wall implantation of a gestational sac is exceedingly rare.
Observation:
- A 34-year-old woman presented with a six-week intrauterine pregnancy diagnosed via ultrasound.
- The gestational sac was found to be implanted within the bladder wall.
Findings:
- Initial treatment with methotrexate resulted in a 22% decrease in beta-human chorionic gonadotropin (β-hCG) levels.
- Despite medical management, the gestational sac ruptured, necessitating emergency surgical intervention.
Implications:
- This case highlights the importance of considering rare implantation sites for ectopic pregnancies.
- Emergency laparotomy and partial cystectomy were successfully performed, leading to an uneventful recovery.
- Management of bladder wall ectopic pregnancy may require a multidisciplinary approach involving gynecologists and urologists.
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