Subcutaneous and scrotal emphysema are rare complications of suprapubic cystostomy. We present here a rare case of an 81-year-old man with colovesical fistula who had severe subcutaneous and scrotal emphysema after percutaneous suprapubic cystostomy was performed. We inserted a new Foley catheter via the urethra, removed the suprapubic cystostomy and incised his scrotal emphysema for open drainage. The patient's subcutaneous emphysema slowly healed.
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