Multidisciplinary Management of Advanced Urothelial Carcinoma with Intestinal Obstruction Secondary to an Infiltrated Bladder Diverticulum: A Rare Case and Literature Review

Urology Department, Ibn Rochd Hospital, Faculty of Medicine and Pharmacy, Hassan II University, Casablanca, Morocco

*Corresponding author: Dr. Oussama Bjane, Urology Department, Ibn Rochd Hospital, Faculty of Medicine and Pharmacy, Hassan II University, Casablanca, Morocco, Tel: +212663207085, E-mail: [email protected]

Received Date: February 20, 2025

Published Date: March 31, 2025

Citation: Eddine MS, et al. (2025). Multidisciplinary Management of Advanced Urothelial Carcinoma with Intestinal Obstruction Secondary to an Infiltrated Bladder Diverticulum: A Rare Case and Literature Review. Mathews J Urol Nephrol. 7(1):24.

Copyrights: Eddine MS, et al. © (2025).

ABSTRACT

Background: Urothelial carcinoma (UC) is the most common form of bladder cancer, with a significant risk of progression to muscle-invasive or metastatic disease if not treated. Although metastases and urological complications are common, rare presentations such as small bowel obstruction secondary to tumor-infiltrated bladder diverticula remain poorly documented. Case Presentation: We report the case of an 81-year-old male with advanced urothelial carcinoma and a history of delayed follow-up and refusal of curative surgery. The patient presented with symptoms of intestinal obstruction. Imaging revealed mechanical small bowel obstruction caused by a bladder diverticulum infiltrated by urothelial carcinoma. Bilateral nephrostomies were performed to address obstructive uropathy, followed by a double-barrel ileostomy to relieve the intestinal obstruction. Postoperatively, the patient was initiated on a palliative chemotherapy regimen combining gemcitabine and carboplatin due to renal impairment and frailty. Discussion: This case highlights the challenges of managing advanced UC with rare complications. Mechanical bowel obstruction from bladder carcinoma is an uncommon phenomenon. Surgical intervention is essential for symptom relief, while tailored systemic therapies address disease progression. Palliative care, including pain management and nutritional support, plays a critical role in improving quality of life. Conclusion: This case underscores the importance of a multidisciplinary approach in managing advanced UC with rare presentations. Timely surgical decompression, combined with palliative chemotherapy and supportive care, can effectively alleviate symptoms and optimize patient outcomes.

Keywords: Urothelial Carcinoma, Bladder Diverticulum, Small Bowel Obstruction, Palliative Care, Gemcitabine, Carboplatin.