Traumatic injury of the bladder and urethra

Alternative names:

bladder injury; bruised bladder; injury of the bladder and urethra; urethral injury

Definition:

Damage to the bladder or urethra caused by external force.

Causes, incidence, and risk factors:

Traumatic injury to the bladder is uncommon. The bladder is located within the bony structures of the pelvis, and is protected from most external forces. Injury may occur if there is a blow to the pelvis that is severe enough to cause the bones to break and bone fragments to penetrate the bladder wall. It may occur secondary to surgery of the pelvis or groin, including hernia repair and abdominal hysterectomy. Injury to the urethra is slightly more common, especially in men. It is rare in women. Injury to the urethra includes cuts, tears, bruises, and similar injuries.

Injury to the bladder or urethra may cause urine to leak into the abdomen, leading to infection (peritonitis). There may be severe bleeding and loss of fluids. Scarring (stricture) or obstruction of the bladder or urethra from swelling may develop, leading to urinary retention. This may eventually cause vesicoureteric reflux or bilateral obstructive nephropathy. There is an increased chance of developing urinary tract infections after injury to the tissues of the urethra or bladder, caused by stasis (stagnation) of retained urine.