A minimally invasive approach to transperitoneal perforation of the bladder during bladder tumour resection

The authors present a case of intraperitoneal rupture of the bladder during transurethral resection of a bladder tumour (TURBT), which was managed conservatively. By passing a urethroscope — which was smaller in diameter than the perforation — through the hole, a small superficial burn was identified on the adjacent bowel and deemed benign, saving this patient with multiple comorbidities from having to undergo an open laparotomy. The bladder was drained with a Foley catheter to allow the perforation to heal and the patient was discharged without incident. By using this approach, a direct view of the neighbouring structures confirmed the integrity of bowel and prevented the need for increased risks associated with a laparotomy.