A case of urinary ascites probably caused by spontaneous bladder rupture

The patient was a 68-year-old woman, who had underwent radical hysterectomy and postoperative radiation therapy thirteen years ago, and suffered from typical symptoms of panperitonitis in 1992 and 1993. Based upon laboratory findings of ascites, intraperitoneal urinary extravasation was suspected as the cause of panperitonitis. However, IVP, cystography, cystos-copy could not show the direct evidence of extravasation. On urodynamic study, poor flow rate, large postvoided residual urine, disturbance of the bladder sensation, and low compliance were present. We considered the neurogenic bladder dysfunction and detrusor weakness due to the previous radical hysterectomy and radiation therapy as the possible causal factors of spontaneous bladder rupture causing urinary extravasation from the bladder in this case.