Presentation
10 weeks post radical prostatectomy. Cystoscopy requested for ? anastamotic leak.
Patient Data
Approximately 150 ml of Urograffin was instilled into the bladder via the urinary catheter under fluoroscopic guidance.
The patient started to feel discomfort, so no more contrast was administered.
No leak was demonstrated at first.
The urethral catheter was then advanced into the bladder manually by approximately 1 cm.
A significant leak of contrast then occurred from the bladder neck.
Case Discussion
This case illustrates the importance of advancing the urethral catheter into the bladder when assessing for bladder and proximal urethral leaks with fluoroscopy.
The catheter balloon is capable of completely sealing the leak, and so has to be advanced or deflated (although this risks dislodging the catheter), in order to reliably assess for a leak.
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