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BMJ Case Rep. 2018 Feb 17;2018. pii: bcr-2016-217769. doi: 10.1136/bcr-2016-217769.

Bladder necrosis: 'A man without a bladder'.

Author information

1
Department of Urology, VU University Medical Center, Amsterdam, The Netherlands.
2
Urology, Spaarne Hospital, Hoofddorp, The Netherlands.

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.

KEYWORDS:

hematuria; infections; urinary tract infections; urological surgery; urology

PMID:
29455174
DOI:
10.1136/bcr-2016-217769
[Indexed for MEDLINE]

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