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Bladder Injury

James R. Yon, MD and Christina Colosimo, DO, MS Reviewed 06/2021
 


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 (2,6)[B]

  • Urinary retention (2,7)[C]

  • Inability to void or olig...

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 othe...

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 (6)[C]. 

DIET

No restrict...

REFERENCES

1
Mahat Y, Leong JY, Chung PH. A contemporary review of adult bladder trauma. J Inj Violence Res. 2019;11(2):101-106.
2
Gomez  RG, Ceballos  L, Coburn  M, et al. Consen...

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. Philadelph...

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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