Complex urinary reconstruction in a case of genitourinary tuberculosis post micturating cystogram bladder perforation

ABSTRACT Voiding cystourethrogram (VCUG) is done for lower urinary tract disorders. Even though easy to perform, can be associated with serious complications if not done properly. A sound knowledge of the technicalities and what is being expected of the study is essential. Different factors such as patient age, underlying diseases, and proper technique are important factors to be kept in mind. Here, we present a 26-year-old female of genitourinary tuberculosis (GUTB) with lower urinary tract symptoms (LUTS). While undergoing evaluation for LUTS refractory to medical therapy, VCUG study was done which was complicated by bladder perforation with spillage of contrast into the peritoneal cavity. Patient was managed conservatively and later complex triple urinary reconstruction was done by left ileocalicostomy with orthotopic neobladder (ONB) with right ureteric reimplantation. While performing VCUG, proper technique should be used and due principals to be followed, especially in cases of GUTB by the attending doctor to avoid rare but grievous complications like bladder perforation. Complex reconstructive surgery is possible but is extremely challenging and should be offered to the patients with very good results.