Open Access

CASE REPORT

Spontaneous rupture of the urinary bladder after pelvic angioembolization: high clinical suspicious for prompt diagnosis is the key

Raidizon Mercedes, Eric Eidelman, Michael Mawhorter, Max Yudovich, Alireza Aminsharifi^*

Department of Urology, Milton S. Hershey Medical Center, Pennsylvania State University, Hershey, PA 17033, USA

* Corresponding Authors: Alireza Aminsharifi. Email: ,

Canadian Journal of Urology 2025, 32(5), 515-520. https://doi.org/10.32604/cju.2025.067973

Received 17 May 2025; Accepted 20 August 2025; Issue published 30 October 2025

Abstract

Background: Spontaneous rupture of the urinary bladder (SRUB) is a rare condition characterized by bladder rupture without any trauma or previous instrumentation. Diagnosing SRUB can be challenging, leading to potential delays in treatment and significant morbidity. Case description: We present a case of a 75-year-old male with a complex medical history, including atrial fibrillation, systemic lupus erythematosus, antiphospholipid syndrome, and chronic anticoagulation, who developed sudden onset gross hematuria and abdominal pain following bilateral internal iliac artery angioembolization for a spontaneous pelvic hematoma in the setting of supratherapeutic anticoagulation. Extraperitoneal bladder perforation was confirmed by CT cystogram. Conservative management failed, and bladder exploration confirmed a friable, ischemic bladder wall defect. Bladder repair was performed with reinforcement using an absorbable fibrin sealant patch. Follow-up imaging demonstrated gradual resolution of urine extravasation, and the patient ultimately regained spontaneous voiding after catheter removal. Conclusions: This report underscores the importance of high clinical suspicion for SRUB in patients with pelvic ischemic insults, particularly after angioembolization. Although rarely reported in the literature, bladder rupture may represent a potential complication in this setting. Early imaging and surgical intervention are critical for favorable outcomes. Clinicians should consider ischemia-related SRUB in differential diagnoses to reduce diagnostic delays and optimize management strategies.

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Keywords

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Supplementary Material

Supplementary Material File

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