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Bladder necrosis: ‘A man without a bladder’
  1. Judith Bosschieter1,
  2. Frederik H K Oudshoorn2,
  3. Eric J H Meuleman1,
  4. Jakko A Nieuwenhuijzen1
  1. 1Department of Urology, VU University Medical Center, Amsterdam, The Netherlands
  2. 2Urology, Spaarne Hospital, Hoofddorp, The Netherlands
  1. Correspondence to Dr Jakko A Nieuwenhuijzen, j.nieuwenhuijzen{at}


Since the use of antibiotics, bladder necrosis has become a rare condition. We report a case of bladder necrosis in a 90-year-old man following urinary retention. After insertion of a transurethral catheter (TUC), 2 L of urine was evacuated. In the following days, the TUC became intermittently blocked. Adequate bladder drainage could not be obtained despite intensive rinsing and placement of a suprapubic catheter. On surgical exploration necrosis of almost the entire bladder wall, except for the trigone, was encountered. Surgical debridement of the non-viable bladder wall without opening the abdominal cavity was conducted, and a TUC was placed in the Retzius cavity to ensure evacuation of urine. Since the patient was haemodynamically unstable, construction of a urinary diversion was waived and urinary drainage of the Retzius cavity by the TUC was accepted, resulting in adequate urinary drainage without compromising renal function.

  • urology
  • urinary tract infections
  • urological surgery
  • hematuria
  • infections
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  • Contributors JB: drafting of the manuscript. FHKO: acquisition of data and critical revision of the manuscript. EJHM: critical revision of the manuscript. JAN: critical revision of the manuscript.

  • Competing interests None declared.

  • Patient consent Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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