Bladder erosion by an intraperitoneal chemotherapy catheter resulting in catheter protrusion through the external urethral meatus.
BACKGROUND
Chemotherapy remains an essential part of the treatment of advanced ovarian cancer. Intraperitoneal (IP) administration has been demonstrated to provide a survival advantage over intravenous chemotherapy in three phase 3 studies. However, IP catheter complications have been a significant factor in aborting IP therapy.


METHODS
A 42-year-old woman receiving IP chemotherapy for carcinoma of the ovary presented with complaints of incontinence. Examination revealed the catheter protruding through the external urethral meatus. The reservoir was intact, and the catheter was immobile. Laparoscopic and cystoscopic evaluation demonstrated that the catheter tip had eroded through the dome of the bladder. The catheter was re-secured to the abdominal wall, and the bladder was laparoscopically repaired. IP chemotherapy was resumed 16 days postoperatively without incident.


CONCLUSIONS
This is the first report of an IP catheter eroding through the bladder. Increased usage of IP chemotherapy may offer new challenges in the diagnosis and management of catheter-related complications.
Bryant
Christopher S
CS
Department of Obstetrics and Gynecology, Division of Gynecologic Oncology, Barbara Ann Karmanos Cancer Institute, Wayne State University, Detroit, MI, USA. csbryant@med.wayne.edu
Shah
Jay P
JP
Triest
Jeffrey A
JA
Schimp
Veronica L
VL
Morris
Robert T
RT
D000328:Adult; D002408:Catheters, Indwelling / Q000009:adverse effects*; D005260:Female; D006801:Humans; D007263:Infusions, Parenteral; D010051:Ovarian Neoplasms / Q000188:drug therapy; D001745:Urinary Bladder Diseases / Q000209:etiology / Q000473:pathology* / Q000601:surgery; D014546:Urinary Catheterization / Q000009:adverse effects*