The bladder is not injured often as the bones in the pelvis protect it from external force and injury. But the bladder can be injured or damaged by forceful blows or pierced by an object normally during another surgical procedure. Timely evaluation and proper management are critical for the best outcomes for recovery and repair if needed.
The two basic types of damage to the bladder are bruises and tears. A bruise is a blunt injury caused by blows to the bladder. A tear is a penetrating injury caused by object piercing through the bladder.
The most common examples of bladder injuries from bruises are from car accidents, falls from high heights, heavy objects falling or heavily pushing on the lower abdomen. The most common tear to the bladder occurs during another surgical procedure and the bladder unfortunately is sliced or nicked and requires immediate surgical intervention from a urologist. Other tears occur from bullet wounds and knife injuries.
Bladder Trauma Signs & Symptoms
Almost everyone who has a blunt injury to the bladder will see blood in their urine. A complete history and physical must be performed by the urologist to accurately determine the cause. Patients that have the bladder injured during another procedure generally have the bladder immediately repaired during the procedure and are not aware of the damage until after the procedure is complete and they are recovering from anesthesia.
Bladder Trauma Diagnosis
Most cases of bladder trauma are visualized during imaging testing to confirm the exact location and extent of the injury.
Bladder Trauma Treatment
Bruised bladders generally do not require any interventions and will heal on their own. Rare cases may require a foley catheter to be placed if there are large blood clots that may not be able to be passed. This catheter may stay in place for a few days to a week depending on the extent of the injury.
Depending on the type, size and location of the tear in the bladder, it may be easily sewn closed through surgery. A catheter is usually left in the bladder for up to two weeks to allow the bladder to rest without being contracted to urinate and to heal completely.