We describe the clinical presentation, radiology and clinical management of four neonates with spontaneous urinary bladder rupture and secondary urinary ascites seen in 1984 and two recent cases seen in 2007. All neonates had normal genitourinary systems on antenatal serial ultrasound scans. The management of these cases ranged from conservative management (n=3) to surgical repair of bladder (n=1). We present a review of the current literature covering management strategies and the possible role of ischemia in the pathogenesis of neonatal bladder rupture which continues to be a clinically challenging entity to diagnose and manage.
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