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Bladder Trauma

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Urological Emergencies

Part of the book series: Current Clinical Urology ((CCU))

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Abstract

Blunt trauma accounts for the majority of bladder injuries presenting to the emergency department. The most common cause of penetrating bladder injury is iatrogenic injury at the time of pelvic surgery.

In this chapter, we describe the anatomy of the bladder, review the evaluation and management of intraperitoneal and extraperitoneal bladder injuries, and discuss the potential complications that can arise after the repair of bladder injuries.

Suspected bladder injury warrants conventional cystography or computed tomography cystography. The combination of a pelvic fracture and gross hematuria is an absolute indication for cystography. Extraperitoneal bladder injuries can be successfully managed by catheter drainage for 2 weeks. Intraperitoneal bladder ruptures should be surgically explored and the bladder fully inspected to rule out bladder neck injury and identify all possible sites of injury. After intraperitoneal bladder injury repair, urethral catheterization alone is adequate to provide bladder drainage during healing. Complications after bladder injury repair can include urinary tract infections, bladder spasms, urinary incontinence, or abscess or fistula formation.

Bladder injuries typically occur as the result of external force and are often associated with pelvic fracture, and/or gross hematuria. Adequate bladder imaging is important in identifying the type and extent of injury. Most extraperitoneal bladder injuries can be managed by prolonged catheter drainage. Intraperitoneal bladder or bladder neck injuries typically demand prompt exploration and repair.

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Author information

Authors and Affiliations

  1. Department of Urology, University of Florida, Gainsville, FL, USA

    Lawrence L. Yeung

  2. Department of Surgery-Urology, Washington University, 4960 Children’s Place, 8242, St. Louis, MO, 63110, USA

    Steven B. Brandes

Authors
  1. Lawrence L. Yeung
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  2. Steven B. Brandes
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Correspondence to Steven B. Brandes .

Editor information

Editors and Affiliations

  1. School of Medicine, Harborview Medical Center, University of Washington, 1959 NE Pacific Street Box 356510, Seattle, 98195, Washington, USA

    Hunter Wessells

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Yeung, L.L., Brandes, S.B. (2013). Bladder Trauma. In: Wessells, H. (eds) Urological Emergencies. Current Clinical Urology. Humana Press, Totowa, NJ. https://doi.org/10.1007/978-1-62703-423-4_5

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  • DOI: https://doi.org/10.1007/978-1-62703-423-4_5

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  • Publisher Name: Humana Press, Totowa, NJ

  • Print ISBN: 978-1-62703-422-7

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