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Evaluation and treatment of bladder rupture
D R Bodner1, A A Selzman, J P Spirnak
1Department of Urology, Case Western Reserve University School of Medicine, Cleveland, OH, USA.
Seminars in Urology
|February 1, 1995
Summary
Bladder rupture, indicated by gross hematuria after trauma, requires prompt diagnosis via cystogram. Treatment depends on rupture type: extraperitoneal may be managed non-surgically, while intraperitoneal needs surgical repair.
Area of Science:
- Urology
- Trauma Surgery
- Diagnostic Imaging
Background:
- Urologic injury is a concern in severe lower abdominal blunt trauma and pelvic fractures.
- Gross hematuria and inability to urinate are key indicators of potential bladder rupture.
Purpose of the Study:
- To outline diagnostic approaches for bladder rupture.
- To delineate management strategies based on rupture type (intraperitoneal vs. extraperitoneal).
Main Methods:
- Review of diagnostic criteria for bladder injury.
- Evaluation of cystogram's role in diagnosis and classification.
- Analysis of treatment outcomes for different bladder rupture types.
Main Results:
- Cystography is diagnostic for bladder rupture, differentiating intraperitoneal from extraperitoneal types.
- Selected extraperitoneal ruptures can be managed non-operatively with catheter drainage and antibiotics.
- Intraperitoneal bladder perforations necessitate surgical intervention and closure.
Conclusions:
- Early identification and appropriate management of bladder injuries are crucial.
- Effective bladder drainage minimizes complications.
- Treatment strategies should be tailored to the specific type of bladder rupture.