Long Standing Emphysematous Cystitis Ends with Chronic Renal Failure and High Intravesical Pressure

A 61-year old male patient with end stage renal failure and severe bilateral hydronephrosis was admitted to our hospital. The patient had pneumaturia since many years with history of several surgeries due to urethral strictures. Computed tomography showed air fluid level in the bladder and bilateral hydronephrosis with air bubbles in the kidneys. Urodynamic study revealed normal bladder volume with increased intravesical pressure during the filling phase. Urine culture was positive for klebsiella pneumonia. Prompt reduction in the serum creatinine level was observed after appropriate medical therapy and catheterization of the bladder. Emphysematous cystitis although it can be managed easily, it may lead to impairment of renal function if no appropriate management was given.