Intraperitoneal Bladder Stones Following Transurethral Cystolithotripsy: A Case Report

Background: Bladder stones are common diseases, constituting 5% of urinary stones. However, iatrogenic bladder rupture with intraperitoneal bladder stones is a rare complication after a transurethral cystolithotripsy (TUCL). Case presentation: A 73-year-old male was sent to the emergency department (ED) with presentations of dyspnea and hematuria after receiving a transurethral cystolithotripsy(TUCL) with laser. Upon arrival, his vital signs were relatively stable. An abdominal X-ray showed a radiopaque lesion within the pelvis. Physical examinations showed diffuse abdominal tenderness with muscle guarding. The initial focused assessment of sonography for trauma (FAST) was positive. Computed tomography (CT) revealed bladder rupture with intraperitoneal bladder stones. The patient received conservative supportive care with antibiotics and foley drainage and was discharged 3 weeks later smoothly. Conclusion: For emergency physicians, bladder rupture should be taken into consideration in patients with intraperitoneal bladder stones following TUCL. Computed tomography remains a standard of diagnosis although ultrasonography is a convenient screening tool for ascites.