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Spontaneous bladder rupture following enterocystoplasty.

J R Sheiner¹, G W Kaplan

¹Division of Urology, University of California, San Diego.

The Journal of Urology

|November 1, 1988

Summary

Spontaneous bladder rupture after enterocystoplasty is a rare complication in patients with neurogenic bladders. Prompt diagnosis and aggressive treatment are crucial to prevent severe outcomes.

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Area of Science:

Urology
Pediatric Surgery
Nephrology

Background:

Enterocystoplasty is a surgical procedure used to augment the bladder, often in patients with neurogenic bladder dysfunction.
Neurogenic bladders can lead to complications such as bladder rupture, particularly after augmentation procedures.

Observation:

Two male adolescent patients with neurogenic bladders managed with enterocystoplasty and artificial urinary sphincters experienced spontaneous bladder rupture.
Cystography, a common diagnostic imaging technique, failed to identify the bladder perforation in both cases.

Findings:

Prompt and aggressive treatment, including intravenous antibiotics, laparotomy, and surgical closure of the perforation, successfully averted serious sequelae.
The study highlights the limitations of cystography in diagnosing bladder ruptures in augmented bladders.

Implications:

A high index of suspicion is necessary for the clinical diagnosis of spontaneous bladder rupture in augmented bladders.
Early and accurate diagnosis is critical for timely intervention and improved patient outcomes in cases of bladder rupture.

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