Percutaneous peritoneal drainage for intraperitoneal bladder perforations during transurethral resection of bladder tumors

Purpose: To demonstrate the safety and efficacy of percutaneous drainage of the peritoneal cavity using an 8F pigtail catheter placed under ultrasound guidance in cases of intraperitoneal perforation of the bladder as a result of transurethral resection of a bladder tumor (TURBT). Patients and Methods: Three patients undergoing TURBT had inadvertent but significant intraperitoneal perforations of the bladder. All patients developed signs and symptoms of peritonism despite large catheters draining the bladder. An 8F pigtail catheter (Boston Scientific, Watertown, MD, USA) was inserted percutaneously under ultrasound guidance with local anesthetic infiltration. Results: All three patients made a good recovery without needing a laparotomy. Cystograms a week later confirmed an intact bladder. Clinical review revealed no sequelae as a result of the perforation or its treatment. Conclusion: Percutaneous drainage of the abdomen in patients with intraperitoneal perforation of the bladder during TURBT is a safe alternative to laparotomy.