Spontaneous Bladder Rupture in Bladder Cancer: A Systematic Review

What is it about?

This systematic review aimed to characterize cases of spontaneous rupture of the urinary bladder in the context of bladder cancer. Thirty cases were included, with the median age of presentation being 59 years old. The most common presenting symptoms were abdominal pain and peritonism, and the majority of patients had urothelial cell carcinoma. The diagnosis was associated with high mortality, raising questions about the role of emergency cystectomy, timing of systemic therapy, and appropriate involvement of palliative care. Spontaneous bladder perforation in the context of bladder cancer is a rare cause of acute abdomen and is associated with advanced disease and poor prognosis.

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Why is it important?

The research is important because it characterizes a rare and serious surgical emergency, spontaneous rupture of the urinary bladder in the context of bladder cancer. It highlights the high mortality rate associated with this condition, which raises important questions about the role of emergency cystectomy, the timing of systemic therapy, and the appropriate involvement of palliative care. Key Takeaways: 1. Spontaneous rupture of the urinary bladder is a rare surgical emergency with significant morbidity and mortality. 2. The condition is often associated with advanced disease (locally and systemically) with a poor prognosis. 3. The most common presentation symptoms are abdominal pain and peritonism. 4. The diagnosis can be delayed due to the obscure presenting signs and symptoms, ambiguous imaging finds, and rarity of the event. 5. The search resulted in 30 cases, including our case report, with 17 male (57%) and 13 female (33%) cases, and a median age of 59. 6. Urothelial cell carcinoma (UCC) was the most common histology found in 16 (53%) patients, followed by squamous cell carcinoma (SCC) in 10 (33%) patients, and the rest were unspecified or had other histologies. 7. Nine patients (30%) died during their initial hospitalization, with most deaths due to complications of UCC and SCC.