Bladder rupture: an acceptable complication of distension therapy?

Bladder rupture complicating prolonged bladder distension is reviewed. Rupture occurred in 7 of 128 distensions for detrusor instability, in 5 of 34 distensions for interstitial cystitis and in one of 4 distensions for reduced bladder capacity of unknown aetiology. Management of extraperitoneal ruptures should be conservative, intraperitoneal ruptures should probably be explored. Rupture was more likely if the bladder wall was diseased, the distension pressure exceeded 145 cm H2O, and the patient was more than 50 years old. The eventual outcome of prolonged bladder distension was not adversely affected by bladder rupture.