Bladder leak post partial cystectomy

Case contributed by Henry Knipe

Presentation

Two weeks post hemicolectomy and partial cystectomy for rectal carcinoma.

Patient Data

Age: 70 years
Gender: Male

Retrograde cystogram

Fluoroscopy

Technique: Retrograde instillation of 80mL 50% Omnipaque 300 via existing IDC in an aseptic manner.

Findings:

Extra-vesical contrast is seen at the superior aspect of the bladder, directed towards but not reaching the anastomotic sutures. Minor reflux of contrast in the distal left ureter.

Conclusion:

Bladder leak from superior aspect. 

Case Discussion

Partial cystectomy is indicated as bladder-sparing surgery for a wide range of benign conditions and there is increasing evidence for its routine use for malignant conditions. No increased complications are reported compared to other laparoscopic urological procedures. 

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