Bladder necrosis: 'A man without a bladder'. (17th February 2018)

• Record Type: Journal Article
• Authors: Bosschieter, Judith; Oudshoorn, Frederik H K; Meuleman, Eric J H; Nieuwenhuijzen, Jakko A
• Is Part Of: BMJ case reports. Volume 2018
• Publication Date: 2018-02-17
• Subjects: urology -- urinary tract infections -- urological surgery -- hematuria -- infections; Medicine -- Case studies -- Periodicals; 610.5
• DOI: 10.1136/bcr-2016-217769
• Languages: English
• ISSNs: 1757-790X

Abstract

Abstract : Since the use of antibiotics, bladder necrosis has become a rare condition. We report a case of bladder necrosis in a 90-year-old man following urinary retention. After insertion of a transurethral catheter (TUC), 2 L of urine was evacuated. In the following days, the TUC became intermittently blocked. Adequate bladder drainage could not be obtained despite intensive rinsing and placement of a suprapubic catheter. On surgical exploration necrosis of almost the entire bladder wall, except for the trigone, was encountered. Surgical debridement of the non-viable bladder wall without opening the abdominal cavity was conducted, and a TUC was placed in the Retzius cavity to ensure evacuation of urine. Since the patient was haemodynamically unstable, construction of a urinary diversion was waived and urinary drainage of the Retzius cavity by the TUC was accepted, resulting in adequate urinary drainage without compromising renal function.