BACK TOTOP Browse A-ZSearchBrowse A-ZABCDEFGHIJKLMNOPQRSTUVWXYZ0-9 E-mail FormEmail ResultsName:Email address:Recipients Name:Recipients address:Message: Print-FriendlyBookmarksbookmarks-menuTraumatic injury of the bladder and urethraInjury - bladder and urethra; Bruised bladder; Urethral injury; Bladder injury; Pelvic fracture; Urethral disruption; Bladder perforationTraumatic injury of the bladder and urethra involves damage caused by an outside force. Causes Types of bladder injuries include: Blunt trauma (such as a blow to the body) Penetrating wounds (such as bullet or stab wounds)The amount of injury to the bladder depends on:How full the bladder was at the time of injury What caused the injuryInjury to the bladder due to trauma is not very common. The bladder is located within the bones of the pelvis. This protects it from most outside forces. Injury may occur if there is a blow to the pelvis severe enough to break the bones. In this case, bone fragments may pierce the bladder wall. Less than 1 in 10 pelvic fractures lead to bladder injury.Other causes of bladder or urethra injury include:Surgeries of the pelvis or groin (such as hernia repair and removal of the uterus). Removal of the uterusHysterectomy is surgery to remove a woman's womb (uterus). The uterus is a hollow muscular organ that nourishes the developing baby during pregnancy...ImageRead Article Now Book Mark Article Tears, cuts, bruises, and other injuries to the urethra. The urethra is the tube that carries urine out of the body. This is most common in men. Straddle injuries. This injury may occur if there is direct force that injures the area behind the scrotum. Deceleration injury. This injury may occur during a motor vehicle accident. Your bladder can get injured if it is full and you are wearing a seatbelt.Injury to the bladder or urethra may cause urine to leak into the abdomen. This may lead to infection.Lead to infectionPeritonitis is an inflammation (irritation) of the peritoneum. This is the thin tissue that lines the inner wall of the abdomen and covers most of t...ImageRead Article Now Book Mark Article Symptoms Some common symptoms are:Lower abdominal pain Abdominal painAbdominal pain is pain that you feel anywhere between your chest and groin. This is often referred to as the stomach region or belly.ImageRead Article Now Book Mark Article Abdominal tenderness Bruising at the site of injury Blood in the urine Blood in the urineBlood in your urine is called hematuria. The amount may be very small and only detected with urine tests or under a microscope. In other cases, the...ImageRead Article Now Book Mark Article Bloody urethral discharge Difficulty beginning to urinate or inability to empty the bladder Difficulty beginning to urinateDifficulty starting or maintaining a urine stream is called urinary hesitancy.ImageRead Article Now Book Mark Article Leakage of urine Painful urination Painful urinationPainful urination is any pain, discomfort, or burning sensation when passing urine.ImageRead Article Now Book Mark Article Pelvic pain Small, weak urine stream Abdominal distention or bloating Shock or internal bleeding may occur after a bladder injury. This is a medical emergency. Symptoms include: ShockShock is a life-threatening condition that occurs when the body is not getting enough blood flow. Lack of blood flow means the cells and organs do n...ImageRead Article Now Book Mark Article Decreased alertness, drowsiness, coma Decreased alertnessDecreased alertness is a state of reduced awareness and is often a serious condition. A coma is the most severe state of decreased alertness from whi...Read Article Now Book Mark Article DrowsinessDrowsiness refers to feeling more sleepy than normal during the day. People who are drowsy may fall asleep when they do not want to or at times whic...Read Article Now Book Mark Article Increased heart rate Heart rateThe pulse is the number of heartbeats per minute.ImageRead Article Now Book Mark Article Decrease in blood pressure Pale skin Sweating Skin that is cool to the touch If there is no or little urine released, there may be an increased risk for urinary tract infections (UTI) or kidney damage.Urinary tract infectionsA urinary tract infection, or UTI, is an infection of the urinary tract. The infection can occur at different points in the urinary tract, including...ImageRead Article Now Book Mark Article Exams and Tests An exam of the genitals may show injury to the urethra. If the health care provider suspects an injury, you may have the following tests:Retrograde urethrogram (an x-ray of the urethra using dye) for injury of urethra Retrograde cystogram (imaging of bladder) for injury of bladderThe exam may also show: Bladder injury or swollen (distended) bladder Other signs of pelvic injury, such as bruising over the penis, scrotum, and perineum Signs of hemorrhage or shock, including decreased blood pressure -- especially in cases of pelvic fracture Tenderness and bladder fullness when touched (caused by urine retention) Tender and unstable pelvic bones Urine in the abdominal cavity A urinary catheter may be inserted once an injury of the urethra has been ruled out. This is a tube that drains urine from the bladder. An x-ray of the bladder using dye to highlight any damage can then be done. Treatment The goals of treatment are to:Control symptoms Drain the urine Repair the injury Prevent complications Emergency treatment of bleeding or shock may include:Blood transfusions Intravenous (IV) fluids Monitoring in the hospital Emergency surgery may be done to repair the injury and drain the urine from the abdominal cavity in case of extensive injury or peritonitis (inflammation of the abdominal cavity).The injury can be repaired with surgery in most cases. The bladder may be drained by a catheter through the urethra or the abdominal wall (called a suprapubic tube) over a period of days to weeks. This will prevent urine from building up in the bladder. It will also allow the injured bladder or urethra to heal and prevent swelling in the urethra from blocking urine flow.If the urethra has been cut, a urological specialist can try to put a catheter in place. If this cannot be done, a tube will be inserted through the abdominal wall directly into the bladder. This is called a suprapubic tube. It will be left in place until the swelling goes away and the urethra can be repaired with surgery. This takes 3 to 6 months. Outlook (Prognosis) Injury of the bladder and urethra due to trauma can be minor or fatal. Short- or long-term serious complications can occur. Possible Complications Some of the possible complications of injury of the bladder and urethra are:Bleeding, shock. Blockage to the flow of urine. This causes the urine to back up and injure one or both kidneys. Blockage to the flow of urineObstructive uropathy is a condition in which the flow of urine is blocked. This causes the urine to back up and injure one or both kidneys.ImageRead Article Now Book Mark Article Scarring leading to blockage of the urethra. Problems completely emptying the bladder. When to Contact a Medical Professional Call the local emergency number (911) or go to the emergency room if you have an injury to the bladder or urethra.Contact your provider if symptoms get worse or new symptoms develop, including:Decrease in urine production Fever Blood in urine Severe abdominal pain Severe flank or back pain Shock or hemorrhage Prevention Prevent outside injury to the bladder and urethra by following these safety tips:Do not insert objects into the urethra. If you need self-catheterization, follow the instructions of your provider. Use safety equipment during work and play. Open ReferencesReferencesBrandes SB, Eswara JR. Upper urinary tract trauma. Partin AW, Dmochowski RR, Kavoussi LR, Peters CA, eds. Campbell-Walsh-Wein Urology. 12th ed. Philadelphia, PA: Elsevier; 2021:chap 90.Lang SC, Shewakramani SN. Genitourinary trauma. In: Walls RM, Hockberger RS, Gausche-Hill M, eds. Rosen's Emergency Medicine: Concepts and Clinical Practice. 10th ed. Philadelphia, PA: Elsevier; 2023:chap 39.AllVideoImagesTogFemale urinary tract - illustration The female and male urinary tracts are relatively the same except for the length of the urethra.Female urinary tractillustrationMale urinary tract - illustration The male and female urinary tracts are relatively the same except for the length of the urethra.Male urinary tractillustrationBladder catheterization - female - illustration A catheter (a hollow tube, often with an inflatable balloon tip) may be inserted into the urinary bladder when there is a urinary obstruction, following surgical procedures to the urethra, in unconscious patients (due to surgical anesthesia, coma, or other reasons), or for any other problem in which the bladder needs to be kept empty (decompressed) and urinary flow assured. The balloon holds the catheter in place for a duration of time.Bladder catheterization - femaleillustrationBladder catheterization - male - illustration Catheterization is accomplished by inserting a catheter (a hollow tube, often with and inflatable balloon tip) into the urinary bladder. This procedure is performed for urinary obstruction, following surgical procedures to the urethra, in unconscious patients (due to surgical anesthesia, coma, or other reasons), or for any other problem in which the bladder needs to be kept empty (decompressed) and urinary flow assured. The balloon holds the catheter in place for a duration of time. Catheterization in males is slightly more difficult and uncomfortable than in females because of the longer urethra.Bladder catheterization - maleillustrationFemale urinary tract - illustration The female and male urinary tracts are relatively the same except for the length of the urethra.Female urinary tractillustrationMale urinary tract - illustration The male and female urinary tracts are relatively the same except for the length of the urethra.Male urinary tractillustrationBladder catheterization - female - illustration A catheter (a hollow tube, often with an inflatable balloon tip) may be inserted into the urinary bladder when there is a urinary obstruction, following surgical procedures to the urethra, in unconscious patients (due to surgical anesthesia, coma, or other reasons), or for any other problem in which the bladder needs to be kept empty (decompressed) and urinary flow assured. The balloon holds the catheter in place for a duration of time.Bladder catheterization - femaleillustrationBladder catheterization - male - illustration Catheterization is accomplished by inserting a catheter (a hollow tube, often with and inflatable balloon tip) into the urinary bladder. This procedure is performed for urinary obstruction, following surgical procedures to the urethra, in unconscious patients (due to surgical anesthesia, coma, or other reasons), or for any other problem in which the bladder needs to be kept empty (decompressed) and urinary flow assured. The balloon holds the catheter in place for a duration of time. Catheterization in males is slightly more difficult and uncomfortable than in females because of the longer urethra.Bladder catheterization - maleillustrationA Closer Look Back pain and sciatica - InDepth(In-Depth) Tests for Traumatic injury of the bladder and urethra CystoscopyRelated Information Hysterectomy(Surgery)Peritonitis(Condition)Reflux nephropathy(Condition)Obstructive uropathy(Condition)Urinary tract infection - adults(Condition)Urinary tract infection - InDepth(In-Depth) Review Date: 4/10/2022 Reviewed By: Kelly L. Stratton, MD, FACS, Associate Professor, Department of Urology, University of Oklahoma Health Sciences Center, Oklahoma City, OK. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team. The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed medical professional should be consulted for diagnosis and treatment of any and all medical conditions. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. No warranty of any kind, either expressed or implied, is made as to the accuracy, reliability, timeliness, or correctness of any translations made by a third-party service of the information provided herein into any other language. © 1997- A.D.A.M., a business unit of Ebix, Inc. Any duplication or distribution of the information contained herein is strictly prohibited. © 1997- All rights reserved. A.D.A.M. content is best viewed in IE9 or above, Firefox and Google Chrome browser.Content is best viewed in IE9 or above, Firefox and Google Chrome browser.
Traumatic injury of the bladder and urethraInjury - bladder and urethra; Bruised bladder; Urethral injury; Bladder injury; Pelvic fracture; Urethral disruption; Bladder perforationTraumatic injury of the bladder and urethra involves damage caused by an outside force. Causes Types of bladder injuries include: Blunt trauma (such as a blow to the body) Penetrating wounds (such as bullet or stab wounds)The amount of injury to the bladder depends on:How full the bladder was at the time of injury What caused the injuryInjury to the bladder due to trauma is not very common. The bladder is located within the bones of the pelvis. This protects it from most outside forces. Injury may occur if there is a blow to the pelvis severe enough to break the bones. In this case, bone fragments may pierce the bladder wall. Less than 1 in 10 pelvic fractures lead to bladder injury.Other causes of bladder or urethra injury include:Surgeries of the pelvis or groin (such as hernia repair and removal of the uterus). Removal of the uterusHysterectomy is surgery to remove a woman's womb (uterus). The uterus is a hollow muscular organ that nourishes the developing baby during pregnancy...ImageRead Article Now Book Mark Article Tears, cuts, bruises, and other injuries to the urethra. The urethra is the tube that carries urine out of the body. This is most common in men. Straddle injuries. This injury may occur if there is direct force that injures the area behind the scrotum. Deceleration injury. This injury may occur during a motor vehicle accident. Your bladder can get injured if it is full and you are wearing a seatbelt.Injury to the bladder or urethra may cause urine to leak into the abdomen. This may lead to infection.Lead to infectionPeritonitis is an inflammation (irritation) of the peritoneum. This is the thin tissue that lines the inner wall of the abdomen and covers most of t...ImageRead Article Now Book Mark Article Symptoms Some common symptoms are:Lower abdominal pain Abdominal painAbdominal pain is pain that you feel anywhere between your chest and groin. This is often referred to as the stomach region or belly.ImageRead Article Now Book Mark Article Abdominal tenderness Bruising at the site of injury Blood in the urine Blood in the urineBlood in your urine is called hematuria. The amount may be very small and only detected with urine tests or under a microscope. In other cases, the...ImageRead Article Now Book Mark Article Bloody urethral discharge Difficulty beginning to urinate or inability to empty the bladder Difficulty beginning to urinateDifficulty starting or maintaining a urine stream is called urinary hesitancy.ImageRead Article Now Book Mark Article Leakage of urine Painful urination Painful urinationPainful urination is any pain, discomfort, or burning sensation when passing urine.ImageRead Article Now Book Mark Article Pelvic pain Small, weak urine stream Abdominal distention or bloating Shock or internal bleeding may occur after a bladder injury. This is a medical emergency. Symptoms include: ShockShock is a life-threatening condition that occurs when the body is not getting enough blood flow. Lack of blood flow means the cells and organs do n...ImageRead Article Now Book Mark Article Decreased alertness, drowsiness, coma Decreased alertnessDecreased alertness is a state of reduced awareness and is often a serious condition. A coma is the most severe state of decreased alertness from whi...Read Article Now Book Mark Article DrowsinessDrowsiness refers to feeling more sleepy than normal during the day. People who are drowsy may fall asleep when they do not want to or at times whic...Read Article Now Book Mark Article Increased heart rate Heart rateThe pulse is the number of heartbeats per minute.ImageRead Article Now Book Mark Article Decrease in blood pressure Pale skin Sweating Skin that is cool to the touch If there is no or little urine released, there may be an increased risk for urinary tract infections (UTI) or kidney damage.Urinary tract infectionsA urinary tract infection, or UTI, is an infection of the urinary tract. The infection can occur at different points in the urinary tract, including...ImageRead Article Now Book Mark Article Exams and Tests An exam of the genitals may show injury to the urethra. If the health care provider suspects an injury, you may have the following tests:Retrograde urethrogram (an x-ray of the urethra using dye) for injury of urethra Retrograde cystogram (imaging of bladder) for injury of bladderThe exam may also show: Bladder injury or swollen (distended) bladder Other signs of pelvic injury, such as bruising over the penis, scrotum, and perineum Signs of hemorrhage or shock, including decreased blood pressure -- especially in cases of pelvic fracture Tenderness and bladder fullness when touched (caused by urine retention) Tender and unstable pelvic bones Urine in the abdominal cavity A urinary catheter may be inserted once an injury of the urethra has been ruled out. This is a tube that drains urine from the bladder. An x-ray of the bladder using dye to highlight any damage can then be done. Treatment The goals of treatment are to:Control symptoms Drain the urine Repair the injury Prevent complications Emergency treatment of bleeding or shock may include:Blood transfusions Intravenous (IV) fluids Monitoring in the hospital Emergency surgery may be done to repair the injury and drain the urine from the abdominal cavity in case of extensive injury or peritonitis (inflammation of the abdominal cavity).The injury can be repaired with surgery in most cases. The bladder may be drained by a catheter through the urethra or the abdominal wall (called a suprapubic tube) over a period of days to weeks. This will prevent urine from building up in the bladder. It will also allow the injured bladder or urethra to heal and prevent swelling in the urethra from blocking urine flow.If the urethra has been cut, a urological specialist can try to put a catheter in place. If this cannot be done, a tube will be inserted through the abdominal wall directly into the bladder. This is called a suprapubic tube. It will be left in place until the swelling goes away and the urethra can be repaired with surgery. This takes 3 to 6 months. Outlook (Prognosis) Injury of the bladder and urethra due to trauma can be minor or fatal. Short- or long-term serious complications can occur. Possible Complications Some of the possible complications of injury of the bladder and urethra are:Bleeding, shock. Blockage to the flow of urine. This causes the urine to back up and injure one or both kidneys. Blockage to the flow of urineObstructive uropathy is a condition in which the flow of urine is blocked. This causes the urine to back up and injure one or both kidneys.ImageRead Article Now Book Mark Article Scarring leading to blockage of the urethra. Problems completely emptying the bladder. When to Contact a Medical Professional Call the local emergency number (911) or go to the emergency room if you have an injury to the bladder or urethra.Contact your provider if symptoms get worse or new symptoms develop, including:Decrease in urine production Fever Blood in urine Severe abdominal pain Severe flank or back pain Shock or hemorrhage Prevention Prevent outside injury to the bladder and urethra by following these safety tips:Do not insert objects into the urethra. If you need self-catheterization, follow the instructions of your provider. Use safety equipment during work and play. Open ReferencesReferencesBrandes SB, Eswara JR. Upper urinary tract trauma. Partin AW, Dmochowski RR, Kavoussi LR, Peters CA, eds. Campbell-Walsh-Wein Urology. 12th ed. Philadelphia, PA: Elsevier; 2021:chap 90.Lang SC, Shewakramani SN. Genitourinary trauma. In: Walls RM, Hockberger RS, Gausche-Hill M, eds. Rosen's Emergency Medicine: Concepts and Clinical Practice. 10th ed. Philadelphia, PA: Elsevier; 2023:chap 39.