Skip to main content

Bladder Injury, Emergency Medicine

Mary E. Johnson Reviewed 06/2017



  • Blunt trauma is the most common mechanism.

  • 10% of pelvic fractures have serious bladder injury.

  • 80–90% of bladder ruptures have pelvic fracture.

  • Mortality: 17–22% overall; 60% if combin...


Signs and Symptoms

  • Gross hematuria

  • Suprapubic pain

  • Difficulty voiding


Establish potential mechanism. 

Physical Exam

Evaluate urethral meatus—if blood is present, do not insert Foley ...



Do not attempt bladder catheterization in the field. 

Initial Stabilization/Therapy

  • ABCs

  • Early urologic consultation

Ed Treatment/Procedures

  • Urologic consultation is needed when bladd...



Admission Criteria

  • Concurrent major trauma requiring admission or observation

  • Surgical intervention required

Discharge Criteria

  • Bladder contusion with no rupture or other major trauma...

Pearls and Pitfalls

  • Any free fluid on CT or US exam should raise suspicion for bladder injury.

  • Unresponsive, altered, and intoxicated patients warrant careful exam.

  • Penetrating injuries to lower abdomen...

Additional Reading

  • Marx  JA, Hockberger  RS, Walls  RM, et al., eds. Rosen's Emergency Medicine Concepts and Clinical Practice. 8th ed. St. Louis, MO: Mosby; 2013.

  • Ramchadani  P, Buckler  PM. Imaging...



  • 665.50 Other injury to pelvic organs, unspecified as to episode of care or not applicable

  • 867.0 Injury to bladder and urethra, without mention of open wound into cavity

  • 867.1 Injury to bladder...

Subscribe to Access Full Content

Sign Up for a 10-Day Free Trial

Sign up for a 10-day FREE Trial now and receive full access to all content.