Bladder injuries often occur once the pelvis is damaged such as in high-velocity vehicular accidents or a fall. Any penetrating wounds, usually from gunshots can rarely damage the bladder. An injury to the bladder can occur unintentionally during surgery that involves the lower abdomen or pelvis, removal of the colon or cesarean delivery.
When bladder injuries are not immediately treated, complications are likely to occur such as the following:
- Frequent and urgent urination
- Persistent bleeding in the urine
- Uncontrollable urine loss
- Leakage of urine into the surrounding tissues
- Abnormal opening between the bladder and the skin or internal organ
- Infection
What are the indications?
The usual indications of a bladder injury include:
- Blood-streaked urine
- Pain in the pelvis and lower abdomen
- Difficulty urination
In case the lowermost region of the bladder is damaged, the individual can suffer from frequent episodes of urination or urinary incontinence.
How is it diagnosed
A diagnosis of bladder injury is usually established by cystography. This is a procedure where a radiopaque dye is administered into the bladder and an X-ray or CT scan is taken to check for the presence of leakage. Remember that bladder injuries that occur during a surgical procedure can be recognized right away and imaging tests are no longer needed.
Treatment
For minor bladder injuries, either tears or bruises, they are treated by inserting a catheter into the urethra for 5-10 days while the bladder heals.
As for extensive bladder injuries or injury due to leakage of urine into the abdominal cavity, surgery is usually carried out to determine the extent of the injury and fix all tears.
The urine can be effectively drained from the bladder by utilizing 1-2 catheters. These catheters are inserted via the urethra and/or directly into the bladder via the skin over the lower abdomen. The catheters are taken out in 7-10 days or once the bladder has satisfactorily healed. In case complications develop, they should be treated.
Once an injury to the bladder is recognized during a surgical procedure, it requires treatment as well.