Injury - bladder and urethra; Bruised bladder; Urethral injury; Bladder injury; Pelvic fracture; Urethral disruption; Bladder perforation
Traumatic injury of the bladder and urethra involves damage caused by an outside force.
Types of bladder injuries include:
The amount of injury to the bladder depends on:
Injury 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:
Injury to the bladder or urethra may cause urine to leak into the abdomen. This may lead to infection.
Some common symptoms are:
Shock or internal bleeding may occur after a bladder injury. This is a medical emergency. Symptoms include:
If there is no or little urine released, there may be an increased risk for urinary tract infections (UTI) or kidney damage.
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:
The exam may also show:
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.
The goals of treatment are to:
Emergency treatment of bleeding or shock may include:
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.
Injury of the bladder and urethra due to trauma can be minor or fatal. Short- or long-term serious complications can occur.
Some of the possible complications of injury of the bladder and urethra are:
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:
Prevent outside injury to the bladder and urethra by following these safety tips:
Brandes 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.BACK TO TOP
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.
Health Content Provider
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. © 1997- 2023 A.D.A.M., a business unit of Ebix, Inc. Any duplication or distribution of the information contained herein is strictly prohibited.