In utero urinary bladder perforation, urinary ascites, and bilateral contained urinomas secondary to posterior urethral valves: clinical and imaging findings

Abstract

We report on a rare in utero appearance of urinary bladder perforation, urinary ascites, and bilateral contained urinomas secondary to posterior urethral valves. The findings on prenatal sonography, postnatal voiding cystourethrography, and magnetic resonance imaging are described.

Prenatal resolution of megacystis possibly caused by spontaneous rupture of posterior urethral valves

“…The first potential cause is bladder rupture. In a few cases, prenatal resolution of megacystis results from bladder rupture because of increased intravesical pressure caused by obstruction of the lower urinary tract [2][3][4][5]. Urinary ascites then presents as a result of bladder rupture.…”

“…On subsequent prenatal ultrasonography, resolution of megacystis is a rare phenomenon. Resolution of megacystis is associated with bladder rupture with the development of urinary ascites or urinoma [2][3][4][5]. We report herein a case of prenatal resolution of megacystis without urinary ascites caused by spontaneous rupture of posterior urethral valves.…”

Transient Urinary Ascites after Vesicocentesis Observed in a Fetus with Megacystis Caused by Posterior Urethral Valve

“…The authors managed the affected fetus conservatively and performed a cesarean section at 40 weeks. The outcome of the neonate was favorable [16] . Interestingly, prenatal spontaneous resolution was noted in 2 cases (cases 1 and 8).…”

In utero Diagnosis of Bladder Perforation with Urinary Ascites

“…Nonmechanical enlargement is caused by neurogenic dysfunction of the bladder [2]. Urine extravasation presenting as ascites can be seen in 25% of fetuses with urethral obstruction [3]. This rare condition is reported in one to two per 10,000 male newborns [4].…”