Trauma to the urinary (vesical) bladder can be caused by a direct or indirect blow to the organ.
It is usually due to blunt trauma and pelvic fracture. Open bladder trauma can be caused by gunshot or stab wounds.
There are different degrees of injury: contusion, intraperitoneal rupture and extraperitoneal rupture.
Symptoms may be masked by other more serious injuries. It manifests with urinary bleeding, lower abdominal pain, difficulty or impossibility to urinate.
It should be suspected in the situations described above and confirmed by an imaging test (retrograde cystography).
In treatment, the goal is to keep the bladder completely decompressed with urinary catheterisation. Patients with intraperitoneal rupture will require surgical intervention to repair the lesion.
- Michael S Runyon, MD, FAAEM, FACEP. Blunt genitourinary trauma: Initial evaluation and management. UpToDate, Abril, 2015.
- Morey AF. Consensus on genitourinary trauma: external genitalia. BJU Int 2004; 94:507.
- Lumen N. Review of the current management of lower urinary tract injuries by the EAU Trauma Guidelines Panel. Eur Urol 2015; 67:925.
- Gomez RG, Ceballos L, Coburn M, et al. Consensus statement on bladder injuries. BJU Int 2004; 94:27.
