Tokuyama Haruna, Tarumi Yosuke, Yamauchi Saiko, Okimura Hiroyuki, Kataoka Hisashi, Kokabu Tetsuya, Yoriki Kaori, Ito Fumitake, Kusuki Izumi, Mori Taisuke
Department of Obstetrics and Gynecology, Kyoto Prefectural University of Medicine, Graduate School of Medical Science, Kyoto, Japan.
Department of Obstetrics and Gynecology, Kyoto Yamashiro General Medical Center, Kyoto, Japan.
Case Rep Womens Health. 2024 Oct 16;44:e00657. doi: 10.1016/j.crwh.2024.e00657. eCollection 2024 Dec.
Partial cystectomy is often performed to treat bladder endometriosis. However, there are no reports of bladder rupture more than 10 years after cystectomy. A 55-year-old woman with a history of laparoscopic bilateral salpingo-oophorectomy and partial cystectomy for bladder endometriosis at the age of 44 years presented with worsening dysuria, decreased urine output, and malaise for over a week. Blood tests revealed elevated creatinine and BUN levels indicating renal failure. Transvaginal ultrasonography and computed tomography revealed large amounts of peritoneal fluid. Abdominocentesis was performed, and peritoneal fluid analysis confirmed the presence of urinary ascites, which was indicative of bladder rupture. Retrograde cystography revealed contrast leakage into the bladder wall. Therefore, a diagnosis was made of with bladder rupture and pseudo-renal failure. If abdominal pain and peritoneal fluid are present after bladder endometriosis surgery, bladder rupture should be considered in the differential diagnosis even after a long postoperative period.
膀胱部分切除术常用于治疗膀胱子宫内膜异位症。然而，尚无膀胱部分切除术后10年以上发生膀胱破裂的报道。一名55岁女性，44岁时因膀胱子宫内膜异位症接受了腹腔镜双侧输卵管卵巢切除术和膀胱部分切除术，现出现排尿困难加重、尿量减少及全身不适超过一周。血液检查显示肌酐和尿素氮水平升高，提示肾衰竭。经阴道超声检查和计算机断层扫描显示大量腹腔积液。进行了腹腔穿刺，腹腔积液分析证实存在尿性腹水，提示膀胱破裂。逆行膀胱造影显示造影剂漏入膀胱壁。因此，诊断为膀胱破裂伴假性肾衰竭。膀胱子宫内膜异位症手术后若出现腹痛和腹腔积液，即使在术后很长一段时间，鉴别诊断时也应考虑膀胱破裂。
