Ces Urol 2024, 28(3):174-178 | DOI: 10.48095/cccu2024023

Incidental finding of emphysematous cystitis a 93-year old diabetic patient with bladder cancer

Martin Malý, Otakar Čapoun, Viktor Soukup, Alžběta Kantorová, Peter Polaček, Vojtěch Fiala

Urologická klinika VFN a 1. LF UK, Praha

Malý M, Čapoun O, Soukup V, Kantorová A, Polaček P, Fiala V. Incidental finding of emphysematous cystitis a 93-year old diabetic patient with bladder cancer. A 93-year-old male presented to the urology outpatient clinic with complaints of a leaking indwelling urinary catheter and suprapubic pain. Our patient had a history of urothelial carcinoma of the bladder, for which he has undergone multiple transurethral resections and recent intravesical chemotherapy instillations. He also has type 2 diabetes mellitus, which is managed with a combination of oral antidiabetic medications and has a history of recurrent urinary tract infections. A CT scan with contrast and an excretory phase and CT cystogram were performed to rule out bladder perforation or a bladder-bowel fistula in the presence of foul-smelling urine. The CT scan did not show any evidence of colo-vesicalor fistula, but it did show evidence of emphysematous cystitis. This case report aims to highlight this rare, often presenting in a subtle manner, but life-threatening urological disease.

Keywords: Emphysematous cystitis, urothelial carcinoma of the bladder, intravesical chemotherapy, diabetes mellitus, computer tomography.

Received: June 10, 2024; Revised: July 28, 2024; Accepted: August 21, 2024; Prepublished online: August 21, 2024; Published: October 1, 2024