Cistitis enfisematosa

we herein report an uncommon case of a diabetic sailor with renal failure and emphysematous cystitis, who presented with hematuria, dysuria, suprapubic pain and obstructive urinary symptoms, initially treated at sea with antibiotics, with an ultrasound showing the presence of gas. this man remained in good general condition with no fever, but it was not possible to isolate bacteria in the cultures because of early use of antibiotics. he was also treated conservatively with surgical debridement of superficial tissues and bladder mucosa, washings with peroxide and iodine solutions and with a suprapubic tube for urinary diversion. the outcome was excellent with bladder preservation and full recovery of his health.