Traumatic injury of the bladder and urethra Health Article

Definition

Traumatic injury of the bladder and urethra involves damage caused by an outside force.

Alternative Names

Injury - bladder and urethra; Bruised bladder; Urethral injury; Bladder injury; Pelvic fracture; Urethral disruption

Causes, incidence, and risk factors

Injuries to the bladder can be divided into:

• Blunt trauma (such as a blow to the body)
• Penetrating wounds (such as bullet or stab wounds)

The nature of the injury to the bladder depends on how full the bladder was at the time of injury and what caused the injury.

Traumatic injury to the bladder is uncommon. Only about 8 - 10% of pelvic fractures are associated with bladder injury. Because the bladder is located within the bony structures of the pelvis, it is protected from most outside forces. Injury may occur if there is a blow to the pelvis that is severe enough to break the bones and cause bone fragments to penetrate the bladder wall.

Other causes of bladder injury include:

• Surgeries of the pelvis or groin (including hernia repair and abdominal hysterectomy)
• Tears, cuts, bruises, and other injuries to the urethra (the tube that carries urine out of the body) -- most common in men.

Injury to the bladder or urethra may cause urine to leak into the abdomen, leading to infection (peritonitis). This type of injury is more common if the bladder is full.

Symptoms

• Abdominal pain, lower
• Blood in the urine or at the urethral opening
• Difficulty beginning to urinate or inability to empty the bladder
• Loss of fluids
• Painful urination
• Pelvic pain
• Severe bleeding
• Small, weak urine stream

Emergency symptoms indicating shock or hemorrhage:

• Decreased alertness
  • Coma
  • Drowsiness, lethargy
• Increased heart rate
• Pale skin
• Sweating
• Skin cool to touch

Note: Symptoms follow a history of injury.

Scarring (stricture) or obstruction of the bladder or urethra from swelling may develop.

If urine retention occurs, there may be an increased risk of urinary tract infections (UTI).