Lecture: Bladder trauma

Question 1

What are the mechanisms of injury in bladder trauma?

Answer 1

(Extra-peritoneal) Pelvic fractiures, contrecoup sheering
(Intra-peritoneal) Sudden rise in intravescicle pressure
(Iatrogenic) Laparoscopic hysterectomy, Caesarean delivery, Urethral surgery

Question 2

What are the clinical features of bladder injury?

Answer 2

Visible haematuria + pelvic fracture / non-visible
haematuria + high-risk pelvic fracture
Inability to void
Abdominal tenderness or distension
Uraemia and elevated creatinine level from Intraperitoneal resorption
Entry/Exit wounds

Question 3

How is bladder trauma diagnosed?

Answer 3

Cystography

Cystoscopy

Question 4

What is the treatment of bladder cancer?

Answer 4

(Extra-peritoneal) Catheter, antibiotic
(Intraperitoneal) Conservative if small + drainage
Suture to close injury