Merck Manual

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Bladder Injuries

By

Noel A. Armenakas

, MD, Weill Cornell Medical School

Reviewed/Revised Feb 2023
VIEW PROFESSIONAL VERSION

A bladder injury often occurs when the pelvis is injured, as in a high-speed motor vehicle crash or a fall. Penetrating wounds, usually resulting from gunshots, can rarely injure the bladder. In addition, a bladder injury may occur unintentionally during surgery involving the lower abdomen or pelvis (such as removal of the uterus [hysterectomy], cesarean delivery, or removal of the colon [colectomy]).

Complications

Symptoms of Bladder Injuries

The most common symptoms of a bladder injury are visible blood in the urine, difficulty in urinating, and pain and distention (swelling) in the pelvis and lower abdomen or during urination. If the lowermost portion of the bladder (where the muscle that helps to control urination is located) has been injured, the person may experience urinary incontinence.

Diagnosis of Bladder Injuries

Treatment of Bladder Injuries

  • Catheterization to drain bladder

  • Sometimes surgery

Minor bladder injuries, either bruises or select small tears (lacerations), may be treated by inserting a catheter into the urethra for 5 to 10 days. The catheter continuously drains urine so the bladder does not fill up, which makes it easier for the bladder to heal.

For more extensive bladder injuries or any injury resulting in leakage of urine into the abdominal cavity, surgery should be done to determine the extent of the injury and to repair all tears. The urine can then be more effectively drained from the bladder using one or, rarely, two catheters. The catheters are inserted through the urethra (a transurethral catheter) and/or directly into the bladder through the skin over the lower abdomen (a suprapubic catheter). These catheters are removed in 7 to 10 days or once the bladder has healed satisfactorily. If complications develop, they must be treated.

When a bladder injury is recognized during a surgical procedure, it should be treated at that time.

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