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

The goals of treatment are control of symptoms, repair of the injury, and prevention of complications. Emergency treatment of bleeding or shock may include intravenous (IV) fluids, blood transfusions, or monitoring in the hospital.

Treatment of peritonitis may include emergency surgery to repair the injury and to drain the urine from the abdominal cavity. Antibiotics may be given to treat peritonitis and to prevent the development of urinary tract infections.

Surgical repair of the injury is usually successful. The bladder may be drained by a catheter through the urethra or the abdominal wall over a period of time (days to weeks). This will prevent urine from accumulating in the bladder, which allows the injured bladder or urethra to heal. This also prevents obstruction of urine flow caused by urethral swelling.

If the urethra has been cut, a consultation with a urological specialist will be needed to place a Foley catheter. If this cannot be done, then a tube will be inserted through the abdominal wall and directly into the bladder. This is called a suprapubic tube. It will be left in place until swelling goes away and the urethra can be surgically repaired, typically within 3-6 months.

Traumatic injury of the bladder and the urethra may range from minor and self-limiting to major and life-threatening. There may be severe, immediate, or long-term complications.

• Bleeding, hemorrhage, shock
• Peritonitis
• Scar formation, obstruction of the urethra
• Urinary retention
• Vesicoureteric reflux
• Acute bilateral obstructive uropathy
• Chronic bilateral obstructive uropathy

Go to the emergency room or call the local emergency number (such as 911), if symptoms of traumatic injury of the bladder or urethra occur -- particularly if there is a history of injury to the area.

Call your health care provider if symptoms worsen or new symptoms develop, including symptoms of shock or hemorrhage (see symptoms), fever, severe abdominal pain, severe flank or back pain, or decrease in urine production.

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