Traumatic injury of the bladder and urethra

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Bladder catheterization, female

Bladder catheterization, male

Female urinary tract

Male urinary tract

Injury - bladder and urethra; Bruised bladder; Urethral injury; Bladder injury; Pelvic fracture; Urethral disruption

• Difficulty beginning to urinate or inability to empty the bladder
• Small, weak urine stream
• Blood in the urine or at the urethral meatus
• Abdominal pain , lower
• Pelvic pain
• Painful urination

Emergency symptoms indicating shock or hemorrhage:

• Decreased alertness
  • Drowsiness , lethargy
  • Coma
• Increased heart rate
• Pale skin
• Sweating
• Skin cool to touch

Note: Symptoms follow a history of injury.

Examination of the genitals may reveal injury to the urethra. If injury is suspected, a retrograde urethrogram should be done to show the structure of the lower urinary tract.

Palpation (examination by touch) over the bladder may show tenderness and bladder fullness,  caused by retention of urine. Examination of the abdomen or rectum may show a bladder injury or swollen (distended) bladder. If the bladder lining has been disturbed, urine may escape from the bladder into abdominal cavity, and the patient may only complain of vague abdominal pain or discomfort associated with inability to empty their bladder.

Other signs of pelvic injury must be considered. These include brusing over the penis, scrotum, and perineum. The person may have tender and unstable pelvic bones.

There may be signs of hemorrhage or shock, including decreased blood pressure -- especially in cases of pelvic fracture.

A Foley catheter (a tube that drains urine from the body) may be inserted.

Review Date: 06/13/2006
Reviewed By: Neil D. Sherman, MD, Urologist, Essex County, NJ. Review provided by VeriMed Healthcare Network.