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Bladder trauma
Background
Overview
Definition
Bladder trauma is defined as any injury to the bladder, often resulting from external trauma, such as blunt or penetrating injuries.
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Pathophysiology
The pathophysiology of bladder trauma often involves damage to the bladder wall due to pelvic fractures or penetrating injuries. This can lead to intraperitoneal or extraperitoneal bladder rupture, depending on the nature and force of the trauma.
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Epidemiology
The prevalence of bladder trauma is estimated at 10% in patients with abdominal trauma.
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Risk factors
Risk factors for bladder trauma include pelvic fractures, blunt abdominal trauma (due to accidents or falls), and invasive medical procedures such as catheter insertion.
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Disease course
Clinically, patients with bladder trauma may present with gross hematuria, suprapubic or abdominal pain, and difficulty in voiding or the inability to void. Bladder trauma can also lead to complications such as urinary fistulas or infections.
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Prognosis and risk of recurrence
The prognosis of bladder trauma can vary based on the severity of the injury and the promptness of treatment. Early recognition and appropriate management can significantly improve outcomes.
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Guidelines
Key sources
The following summarized guidelines for the evaluation and management of bladder trauma are prepared by our editorial team based on guidelines from the European Association of Urology (EAU 2025), the American College of Radiology (ACR 2019), the Eastern Association for the Surgery of Trauma (EAST 2019), the World Society of Emergency Surgery (WSES/AAST 2019), and the American Urological Association (AUA ...
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Diagnostic investigations
CT: as per ACR 2019 guidelines, obtain pelvic CT with bladder contrast (CT cystography) for initial evaluation of suspected penetrating trauma to the lower urinary tract.
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Retrograde cystography
Medical management
Surgical interventions
Indications for surgery
As per EAU 2025 guidelines:
Perform surgery in patients with blunt extraperitoneal bladder injuries in cases of bladder neck involvement and/or associated injuries requiring surgical intervention.
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Perform surgical exploration and repair in patients with blunt intraperitoneal injuries.
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