Spontaneous bladder rupture following enterocystoplasty.

We treated 2 male patients with spontaneous bladder rupture following enterocystoplasty. Both adolescents had neurogenic bladders that were managed with enterocystoplasty and an artificial urinary sphincter. With prompt aggressive therapy including intravenous antibiotics, laparotomy and closure of the perforation serious sequelae were averted. Cystography failed to demonstrate the lesion in either case. The failure of cystography to diagnose these ruptures is especially disturbing. These patients demonstrate that in augmented bladders a high index of suspicion may be necessary to diagnose ruptures clinically. Early diagnosis is critical so that aggressive therapy may be instituted.