An uncommon infection after transurethral resection for bladder tumor: Emphysematous cystitis

Introduction: Emphysematous cystitis (EC) is a rare but potentially life-threatening form of complicated urinary tract infection, typically associated with diabetes mellitus and urological instrumentation. Computed tomography is considered the most sensitive diagnostic tool. Case Report: We present a 51-year-old male with a history of diabetes mellitus who developed EC three weeks after undergoing transurethral resection (TUR) for a large bladder tumor. The patient was admitted with severe dysuria and suprapubic pain. Laboratory findings were leukocytosis, hyperglycemia, elevated C-reactive protein, and impaired renal function. Computed tomography (CT) revealed diffuse bladder wall thickening and intramural air densities localized at the previous TUR site. Broad-spectrum intravenous antibiotics, bladder drainage with an indwelling catheter, and daily bladder irrigation were performed. No pathogens grew in urine and blood cultures. After 14 days, clinical and radiological findings completely resolved. Conclusion: Emphysematous cystitis is an uncommon, but serious infection that can develop after urological interventions such as TUR. Early diagnosis with CT, prompt antibiotic therapy, and effective bladder drainage are essential for favorable outcomes. Clinicians should be aware of this possibility in patients with diabetes undergoing extensive bladder tumor resections.