Bladder malignancy as a cause of spontaneous bladder rupture: A systematic review

Abstract

ObjectivesTo characterise cases of spontaneous rupture of the urinary bladder in the context of bladder cancer.MethodsA systematic review was performed to characterise cases of spontaneous bladder rupture in patients with bladder cancer. The Preferred Reporting Items for Systematic Reviews and Meta‐Analyses (PRISMA) system was utilised, with databases being searched for relevant cases. Patient characteristics were extracted, including age, sex, presenting signs and symptoms, management modalities, tumour histology and mortality.ResultsThirty cases were included. Seventeen (57%) were male, and the median age of presentation was 59. Abdominal pain and peritonism were the most common presenting symptoms, in 80% and 60% of patients, respectively. Most patients (n = 16, 53%) had urothelial cell carcinoma. Nine patients (30%) died during their initial hospitalisation.ConclusionSpontaneous bladder perforation in the context of bladder cancer is a rare cause of acute abdomen. The diagnosis is associated with high mortality, highlighting the aggressive nature of the malignancies that cause spontaneous bladder rupture. This raises important questions about the role of emergency cystectomy, the timing of systemic therapy and the appropriate involvement of palliative care.

Urothelial Cell Carcinoma of the Bladder and Urinary Bladder Rupture as a Rare Cause of Acute Peritonitis: A Case Report

“…Spontaneous rupture of the urinary bladder is a rare event that occurs when the bladder wall is ruptured without surgical intervention or trauma [1]. It presents with non-specific clinical signs and investigation findings, often leading to delayed or missed diagnosis.…”