Rupture of the urinary bladder, a potentially serious condition

During the years 1969 to 1983, 61 patients with rupture of the urinary bladder were treated at the Department of Surgery, University of Turku, Finland. The etiology of the injury was accident trauma in 48%, iatrogenic trauma in 28%, minor trauma in association with misuse of alcohol in 21% and other causes in 3% of the cases. In the first three groups the most reliable signs for diagnosing rupture were abdominal pain and tenderness, together with macroscopic or microscopic haematuria. In some cases cystography was of decisive importance in making the diagnosis. The prognosis for this condition, especially when it was associated with other injuries, was serious. Nine patients (14.8%) died and 35 patients (57.3%) had postoperative complications, for the most part infection-related. Fifty-nine patients underwent operative exploration and repair of the bladder, followed by urethral catheter drainage. Two patients were treated conservatively, with an indwelling urinary catheter only.