Acute urinary retention caused by a large peritoneal inclusion cyst: a case report

Abstract

Background: Pelvic masses have been known to cause bladder symptoms and compression. This is the first documented case of a large peritoneal inclusion cyst causing acute urinary retention from bladder outlet obstruction.

Case: A 36-year-old woman, gravida 2, para 2, presented to the gynecology clinic with an indwelling Foley catheter that was placed at an outside hospital secondary to acute urinary retention. Computed tomography, performed several days earlier for complaints of progressively worsening lower abdominal and pelvic pain, revealed a 10-cm, complex, cystic mass within the pelvis between the rectum and sigmoid colon, with anterior displacement of the bladder. The patient's past surgical history included a total abdominal hysterectomy as well as separate exploratory laparotomy for resection of a 20-cm peritoneal inclusion cyst and a prophylactic bilateral salpingo-oophorectomy. Due to the acute urinary retention and worsening pain, the decision was made to proceed with laparoscopic removal and drainage of the mass, which turned out to be consistent with a recurrent peritoneal inclusion cyst. Symptom relief was immediate.

Conclusion: A large, recurrent, peritoneal inclusion cyst obstructed the bladder neck and presented as acute urinary retention. Laparoscopy relieved the symptoms.