Intravesical fat entrapment as a cause of failure of extraperitoneal bladder perforation to heal spontaneously.

We report a case of intravesical fat entrapment leading to failure of extraperitoneal bladder perforation to heal spontaneously. A 68-year-old woman underwent trans-abdominal hysterectomy complicated by an extraperitoneal bladder perforation. Despite prolonged catheterization, cystographic leakage persisted after 3 months. Bladder imaging and cystoscopy demonstrated a mass of perivesical pelvic fat protruding into the bladder cavity. The patient was symptomatic with pain and persistent urinary tract infection with episodes of sepsis. A transurethral resection of the mass was performed which led to bladder healing and resolution of symptoms.