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Bladder Injury

Reviewed 06/2018
 


BASICS

DESCRIPTION

  • The bladder is well-protected deep within the bony pelvis.

  • Bladder injury is caused by trauma, iatrogenic surgical complication, or spontaneous rupture.

    • The mechanism of traumatic inju...

DIAGNOSIS

HISTORY

  • Determine mechanism of injury: trauma (blunt or penetrating), surgery, or spontaneous.

  • Gross hematuria and pelvic fracture (1,3)[B]

  • Urinary retention (1,4)[C]

  • Inability to void or oligur...

TREATMENT

GENERAL MEASURES

  • Place a catheter to drain the bladder.

  • Control pain.

  • Short course of prophylactic antibiotics

  • Obtain appropriate labs and imaging studies.

  • See “Surgery/Other Procedures” for deta...

ONGOING CARE

FOLLOW-UP RECOMMENDATIONS

Patients with bladder perforation should undergo a cystogram prior to catheter removal around 10 to 14 days to rule out a persistent leak (3)[C]. 

DIET

No restricti...

REFERENCES

1
Gomez RG, Ceballos L, Coburn M, et al. Consensus statement on bladder injuries. BJU Int.  2004;94(1):27–32. {L-End} [View Abstract on OvidMedline]
2
Pereira BM, de Campos CC, Calderan ...

ADDITIONAL READING

Morey AF, Dugi DDIII. Genital and lower urinary tract trauma. In: Wein AJ, Kavoussi LR, Partin AW, et al, eds. Campbell-Walsh Urology. 10th ed. Philadelphia, PA: Elsevier-Saunders...

SEE ALSO

Hematuria 

CODES

ICD10

  • S37.20XA Unspecified injury of bladder, initial encounter

  • S37.29XA Other injury of bladder, initial encounter

  • S37.22XA Contusion of bladder, initial encounter

  • S37.23XA Laceration of bladder, i...

CLINICAL PEARLS

  • Bladder injuries are usually associated with blunt trauma and pelvic fracture.

  • Gross hematuria is the most common presenting sign.

  • A cystogram needs to be performed when a bladder injury...

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