Successful Percutaneous Embolization of a Persistent Extraperitoneal Bladder Leak

Excerpt

In contradistinction to intraperitoneal bladder injuries, isolated extraperitoneal bladder rupture (EPR) is traditionally managed nonoperatively via continuous decompression by transurethral or suprapubic catheterization [1, 2]. Once placed, such catheters are maintained anywhere from 10 to 21 days, thereby allowing evacuation of blood and healing by secondary intention of the bladder wall [3]. Although this treatment strategy is the accepted standard for EPR, only retrospective data exist to support its use [2]. Correire and Sandler’s [4] 1986 single-center study found 39 patients with EPR and a success rate of 87 % for catheterization alone. Kotkin and Koch’s [5] 1995 article included similar data from a single-center study with 85 % success of their 70 patients, identifying complex pelvic injuries as a major predictor of failure of nonoperative management. To our knowledge, there have been no reported cases of a percutaneous technique for the repair. …