Spontaneous Extraperitoneal Bladder Rupture in a 46-Year-Old Woman: An Unusual Presentation

Spontaneous bladder rupture is a rare and potentially life-threatening condition, usually occurring intraperitoneally and in association with an underlying bladder or systemic disorder.We report a 46-yearold woman with no significant medical history who presented with sudden hypogastric pain and acute urinary retention.Computed tomography urography demonstrated a defect in the anterior bladder wall with extravasation of contrast medium, consistent with extraperitoneal bladder rupture.Surgical exploration revealed an approximately 4-cm irregular and ragged perforation of the anterior bladder wall.The defect was repaired without tension using a two-layer suture technique.Histopathological examination of the rupture margins showed no malignancy.Follow-up cystography at two weeks demonstrated an intact bladder without contrast extravasation.No underlying predisposing condition was identified.Spontaneous extraperitoneal bladder rupture is exceptionally uncommon.This case emphasizes the importance of considering bladder rupture in patients with acute hypogastric pain and urinary retention, even in the absence of trauma or an obvious predisposing factor.