Purple Urine Bag Syndrome in a Young Adult With Neurogenic Bladder Secondary to Partial Caudal Regression Syndrome: A Case Report

Purple urine bag syndrome (PUBS) is a rare, benign condition associated with long-term urinary catheterization, caused by bacterial metabolism of urinary indoles into blue and red pigments. We present the case of a 22-year-old female with a neurogenic bladder secondary to partial caudal regression syndrome who developed PUBS. The patient presented with a history of purple discoloration of her catheter bag. She had been on continuous bladder drainage since age three, with routine catheter changes every two weeks. Management involved patient reassurance and emphasis on catheter hygiene. A permanent surgical solution for her underlying neurogenic bladder was not pursued after a multidisciplinary review concluded that available options were either anatomically nonviable or unacceptable to the patient. This case highlights the importance of recognizing PUBS to alleviate patient anxiety, provides a clear rationale for conservative management, and underscores the challenges of managing chronic bladder dysfunction in patients with complex congenital anomalies. The patient provided broad written informed consent for publication.