Extensive necrosis of the bladder with hypostatic abscess: a late complication after radiotherapy

Late urological complications after radiotherapy of a primary tumor in the pelvis are rare but challenging. We report a case of extensive bladder necrosis with hydronephrosis and sepsis nearly 45 years after radiotherapy.

An 80-year-old woman with infected hydronephrosis and with a history of radiotherapy due to cervical carcinoma was treated with JJ stenting. Due to the absence of any improvement, we performed a computed tomography which showed bilateral hypostatic abscesses in both thighs that were not apparent at first look. The initiated series of diagnostics and therapies finally led to complete healing. The patient was discharged after 6 months with completely healed wounds and nearly normal renal parameters.

Special emphasis should be put here on the extremely long latency period, the utmost importance of the past history, the individualized surgical management, and the notion about late complications after radiotherapy.