RESUMEN
BACKGROUND: In this article, we present a case of iatrogenic bladder neck rupture due to catheter insertion in a 94-year-old comorbid male patient. CASE SUMMARY: The patient, who had a urethral catheter inserted in the palliative service 3 d ago, was consulted because the catheter did not work. Because the fluid given to the bladder could not be recovered, computed tomography was performed, which revealed that the catheter had passed the bladder neck first into the retrovesical area then into the intraabdominal area. The appearance of the anterior urethra and verumontanum was normal at cystoscopy. However, extremely severe stenosis of the bladder neck, and perforated posterior wall of the urethral segment between the prostatic urethra and the bladder neck were observed. Internal urethrotomy was applied to the bladder neck with a urethrotome. An urethral catheter was sent over the guide wire into the bladder. The patient was followed in the palliative care service and the catheter was removed 7 d later. No extravasation was observed in the control urethrography. CONCLUSION: Although catheter insertion is a simple and frequently performed procedure in hospitalized patients, it is necessary to avoid unnecessary extra-indication catheter insertion.
RESUMEN
BACKGROUND: Prostatic urethral lift (PUL) therapy is an alternative to minimally invasive and other surgeries in younger patients who want to preserve their sexual and ejaculatory functions, and in elderly male patients with benign prostatic hyperplasia who cannot be anesthetized because of the risk of anesthesia. The procedure can be performed as an outpatient and without anesthesia, and complications are few and temporary. In long-term follow-up, encrustations that require retreatment are rarely seen. CASE SUMMARY: In our case, a 62-year-old prostate patient who had a PUL operation 8 years ago and had a stone on the PUL material near the bladder neck was treated. The patient's stone was removed by endoscopic cystolithotripsy using pneumatic fragmentation. Bipolar transurethral resection of the prostate was applied to the patient in the same session. After the patient's 7-year follow-up, the patient's complaints relapsed, and cystoscopy was performed again. In cystoscopy, stone formation adjacent to the wall was observed at the junction of the bladder neck to the left lateral wall. The stone was fragmented with a pneumatic lithotripter. CONCLUSION: Placing clips too close to bladder neck in the PUL procedure may result in clip migration.