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Traumatic injury of the bladder and urethra - Overview

Alternative Names

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

Definition of Traumatic injury of the bladder and urethra:

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

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 or uretal 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.
  • Straddle injuries (direct force accidents that injury the scrotum area between a man's legs)
  • Deceleration injury (for example, a motor vehicle accident that occurs with a full bladder while wearing seatbelt)

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.

  • Reviewed last on: 6/21/2010
  • Linda J. Vorvick, MD, Medical Director, MEDEX Northwest Division of Physician Assistant Studies, University of Washington, School of Medicine; Scott Miller, MD, Urologist in private practice in Atlanta, Georgia. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

References

Morey AF, Rozanski TA. Genital and lower urinary tract trauma. In: Wein AJ, ed. Campbell-Walsh Urology. 9th ed. Philadelphia, Pa: Saunders Elsevier; 2007:chap 83.

Runyon MS. Genitourinary system. In: Marx JA, ed. Rosen’s Emergency Medicine: Concepts and Clinical Practice. 7th ed. Philadelphia, Pa: Mosby Elsevier; 2009:chap 44.

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