@Article{cju.2025.067973,
AUTHOR = {Raidizon Mercedes, Eric Eidelman, Michael Mawhorter, Max Yudovich, Alireza Aminsharifi},
TITLE = {Spontaneous rupture of the urinary bladder after pelvic angioembolization: high clinical suspicious for prompt diagnosis is the key},
JOURNAL = {Canadian Journal of Urology},
VOLUME = {32},
YEAR = {2025},
NUMBER = {5},
PAGES = {515--520},
URL = {http://www.techscience.com/CJU/v32n5/64375},
ISSN = {1488-5581},
ABSTRACT = { <b>Background:</b> 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. <b>Case description:</b> 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. <b>Conclusions:</b> 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.},
DOI = {10.32604/cju.2025.067973}
}