Bladder perforation due to laparoscopic peritoneal dialysis catheterization: A case report and literature review

Complications related to the peritoneal dialysis (PD) catheter are the primary cause of treatment failure in PD, and bladder perforation is a rare complication of PD catheter placement. To date, there have been no reported cases of bladder perforation occurring during laparoscopic PD catheter placement.

An 80-year-old woman was admitted to Shaoxing Second Hospital due to a decade-long history of high blood creatinine levels. She was diagnosed with end-stage renal disease and underwent laparoscopic PD catheter placement. On the third day post-operation, she experienced frequent urination and urgency during her initial peritoneal dialysis fluid exchange.

The urine analysis indicated sterility. Both ultrasound and computed tomography scans suggested that the PD catheter was positioned in the bladder. We suspect a bladder perforation following laparoscopic placement of the PD catheter.

The patient underwent emergency surgery, during which the PD catheter was removed and subsequently replaced using laparoscopy. Additionally, due to a bladder perforation, peritoneal dialysis was temporarily suspended for 10 days postoperatively.

On the 11th postoperative day, the patient underwent a low-dose peritoneal dialysis, and the procedure was uneventful.

During laparoscopy, PD catheter placement still carries the risk of rare complications such as bladder perforation. If postoperative PD catheter patients experience urinary urgency and frequency, there should be a high suspicion of bladder perforation. Early diagnosis and surgical intervention are crucial for improving patient prognosis.