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Case Reports in Urology
Volume 2013 (2013), Article ID 765704, 3 pages
Case Report

Intraperitoneal Urinary Bladder Perforation Observed in a Patient with an Indwelling Urethral Catheter

Department of Urology, Fujita General Hospital, Kunimi-Town, Fukushima 969-1793, Japan

Received 28 June 2013; Accepted 4 August 2013

Academic Editors: F. Ramezanzadeh and F. M. Solivetti

Copyright © 2013 Soichiro Ogawa et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


This report describes a rare case of an 86-year-old man with an indwelling urethral catheter who developed severe abdominal pain and was diagnosed with intraperitoneal urinary bladder perforation. A home-visiting nurse suspected catheter obstruction and performed a catheter exchange. However, bladder irrigation could not subsequently be performed. Computed tomography of the abdomen and pelvis after transurethral perfusion of contrast medium demonstrated extravasation of the contrast material into the peritoneal cavity. Furthermore, the Foley catheter balloon was positioned in the peritoneal cavity through the bladder. The patient was diagnosed with peritonitis due to spontaneous intraperitoneal perforation of the urinary bladder, and exploratory laparotomy was performed. During exploration, a perforated tear at the top of the bladder was discovered where the Foley catheter had penetrated the bladder. The Foley catheter balloon was floating freely in the peritoneal cavity. There was no evidence of pathologic lesions, such as cancer or inflammatory mass at the site of the injured peritoneum. Successful closure of the damaged peritoneum and bladder was performed. Since the proportion of elderly individuals continues to increase in the general Japanese population, the incidence of the chronic Foley catheterization is expected to increase. Therefore, clinicians should be aware of this potential complication.