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A Case of Bladder Perforation With Rectal Impalement Injury

Tatsuma Juichi¹, Atsushi Fujikawa¹

¹Department of Urology Yokosuka City Hospital Yokosuka Japan.

IJU Case Reports

|November 4, 2025

Abstract

Introduction:

Combined rectal impalement (RI) and bladder perforation (BP) is an extremely rare injury pattern, with limited case reports and no established consensus on their diagnosis and management.

Case Presentation:

A 50-year-old man sustained a perianal impalement injury caused by a metal rod at a construction site. He presented with perianal pain and gross hematuria (GH). Imaging revealed RI and extraperitoneal BP. A colostomy was performed on the same day as the injury, and transurethral coagulation of the bladder (TUC) was performed on the 6th day, during which a bladder mucosal defect was identified. Postoperatively, the GH reduced, and no persistent voiding or defecation dysfunction was observed.

Conclusion:

In patients with RI and GH, concomitant BP should be suspected. Although colostomy is almost always required for rectal injury, extraperitoneal BP can be cured with transurethral intervention and catheterization.

Keywords:

bladder perforation rectal impalement transurethral coagulation

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