title: A Case of Post-radiotherapy Urethral Stricture with Spontaneous Bladder Rupture, Mimicking Obstructive Uropathy due to Cancer Metastasis.
abstract: Non-traumatic, spontaneous urinary bladder rupture is a rare complication of urethral stricture. Furthermore, its symptoms are often nonspecific, and misdiagnosis is common. The authors experienced a case of urethral stricture with spontaneous bladder rupture and bilateral hydronephrosis, mimicking obstructive uropathy attributed to cancer metastasis. A 55-year-old woman was admitted with abdominal pain and distension, oliguria, and an elevated serum creatinine level. She had undergone radical hysterectomy for uterine cervical cancer and received post-operative concurrent chemoradiation therapy 13 years previously. Non-contrast enhanced computed tomography showed massive ascites and bilateral hydronephrosis. The initial diagnosis was acute kidney injury due to obstructive uropathy caused by malignant disease. After improvement of her renal function by bilateral percutaneous nephrostomy catheterization, contrast-enhanced computed tomography and a cytologic examination of ascites showed no evidence of malignancy. However, during retrograde pyelography, a severe urethral stricture was found, and subsequent cystography showed leakage of contrast into the peritoneal cavity and cystoscopy revealed a defect of the posterior bladder wall. After urethral dilatation and primary closure of the bladder wall, acute kidney injury and ascites were resolved.
authors: Division of Nephrology and Hypertension, Department of Internal Medicine, Inha University College of Medicine, Incheon, Korea.
authors: Jun Young
authors: JY
authors: Shin
authors: Department of Urology, Inha University College of Medicine, Incheon, Korea.
authors: Sang Min
authors: SM
authors: Yoon
authors: Division of Nephrology and Hypertension, Department of Internal Medicine, Inha University College of Medicine, Incheon, Korea.
authors: Hyuck Jae
authors: HJ
authors: Choi
authors: Division of Nephrology and Hypertension, Department of Internal Medicine, Inha University College of Medicine, Incheon, Korea.
authors: Si Nae
authors: SN
authors: Lee
authors: Division of Nephrology, Department of Internal Medicine, Yanbian University Hospital, Yanji, Jilin Province, China.
authors: Hai Bong
authors: HB
authors: Kim
authors: Division of Nephrology and Hypertension, Department of Internal Medicine, Inha University College of Medicine, Incheon, Korea.
authors: Woo Chul
authors: WC
authors: Joo
authors: Division of Nephrology and Hypertension, Department of Internal Medicine, Inha University College of Medicine, Incheon, Korea.
authors: Joon Ho
authors: JH
authors: Song
authors: Division of Nephrology and Hypertension, Department of Internal Medicine, Inha University College of Medicine, Incheon, Korea.
authors: Moon-Jae
authors: MJ
authors: Kim
authors: Division of Nephrology and Hypertension, Department of Internal Medicine, Inha University College of Medicine, Incheon, Korea.
authors: Seoung Woo
authors: SW
authors: Lee
keywords: Acute kidney injury; Hydronephrosis; Radiotherapy; Spontaneous rupture; Urinary bladder