Spontaneous Rupture of Urinary Bladder: A Systematic Review of Case Series and Reports

What is it about?

This review analyzed 278 cases of spontaneous rupture of the urinary bladder (SRUB) to describe demographics, associated comorbidities, clinical presentation, diagnosis, management, and outcomes. The median age of patients was 47.5 years, and the most common presenting symptoms were abdominal pain (76%). The diagnosis was confirmed in 42% of cases during explorative surgery. Pelvic radiation (13%) and alcohol intoxication (11%) were the most common associated factors. Intraperitoneal rupture was more common (89%), and the dome of the bladder was most frequently involved (55%). The overall mortality was 15%. The review highlights the importance of increased awareness and maintaining a high index of suspicion for this condition.

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Why is it important?

This research is important because it systematically reviews all cases of spontaneous rupture of the urinary bladder (SRUB) and describes the demographic data, associated comorbidities, clinical presentation, diagnosis, relevant laboratory findings, associated factors, management, morbidity, and mortality associated with the presentation of SRUB. This review emphasizes the high rate of misdiagnosis and the challenge in confirming the diagnosis, highlighting the importance of increased awareness and maintaining a high index of suspicion for this condition. Key Takeaways: 1. SRUB predominantly affects young adults and the elderly, with an almost equal incidence among males and females. 2. The major presenting symptoms are abdominal pain, nausea, vomiting, abdominal distention, and difficulty in passing urine or acute urinary retention. 3. The underlying pathogenesis of SRUB is attributed to a compromised bladder wall integrity in combination with increased intravesical pressure and/or increased intra-abdominal pressure. 4. Radiation exposure and alcohol intoxication are the most common associated factors. 5. Neurogenic bladder is also a prevalent associated factor, and the diagnosis is often made during explorative surgery.