Rare complications of bladder perforation following the transurethral resection of a bladder tumour with the immediate intravesical instillation of mitomycin C

We present a case of a man in his late 70s with a history of peritonitis and vesical stones who developed severe complications after undergoing the transurethral resection of a bladder tumour (TURBT) followed by immediate mitomycin C (MMC) instillation. The patient experienced abdominal pain and haematuria and was subsequently diagnosed with pancytopenia and extraperitoneal bladder rupture. He later developed a urinary tract infection, leading to methicillin-resistant Staphylococcus aureus-related septic pulmonary embolism (SPE). Despite intensive care efforts, his condition deteriorated, culminating in discharge for impending death. Pancytopenia and SPE represent rare but severe complications associated with post-TURBT immediate intravesical MMC instillation. Clinicians must be vigilant for symptoms of bladder perforation and consider deferring to chemotherapy in such cases.