An inventive two-catheter technique to manage an extra-peritoneally ruptured and prolapsed bladder causing obstructive uropathy

An 84 year-old lady presented with extraperitoneal bladder rupture following a fall, in the setting of procidentia causing longstanding bilateral ureteric obstruction. Imaging demonstrated that while part of her bladder was in the pelvis, a large component was within the prolapse. After catheterising the pelvic portion, CT Cystogram confirmed decompression of the bladder in the pelvis, but on-going distension of the bladder in the prolapse. A second urethral catheter was placed in to the prolapsed portion of the bladder facilitating easy manual reduction of the prolapse. This reduction resolved the ureteric obstruction and was maintained with a pessary.