Treatment:

The goals of treatment are to:

• Control symptoms
• Repair the injury
• Prevent complications

Emergency treatment of bleeding or shock may include:

• Blood transfusions
• Intravenous (IV) fluids
• Monitoring in the hospital

Treatment of peritonitis may include emergency surgery to repair the injury and drain the urine from the abdominal cavity. Antibiotics may be given to treat peritonitis and to prevent urinary tract infections.

Surgical repair of the injury is usually successful. The bladder may be drained by a catheter through the urethra or the abdominal wall over a period days to weeks. This will prevent urine from building up in the bladder, allowing the injured bladder or urethra to heal. This also prevents swelling in the urethra from blocking urine flow.

If the urethra has been cut, a urological specialist can place a Foley catheter. If this cannot be done, a tube will be inserted through the abdominal wall and directly into the bladder. This is called a suprapubic tube. It will be left in place until swelling goes away and the urethra can be surgically repaired. This typically takes 3 - 6 months.

Expectations (prognosis):

Traumatic injury of the bladder and the urethra may range from minor to major and life-threatening. There may be severe, immediate, or long-term complications.

Complications:

• Acute bilateral obstructive uropathy
• Bleeding, hemorrhage, shock
• Chronic bilateral obstructive uropathy
• Peritonitis
• Scar formation, obstruction of the urethra
• Urinary retention
• Vesicoureteric reflux

Calling your health care provider:

Go to the emergency room or call the local emergency number (such as 911), if you have symptoms of traumatic injury of the bladder or urethra -- particularly if there is a history of injury to the area.

Call your health care provider if symptoms worsen or new symptoms develop, including:

• Decrease in urine production
• Fever
• Severe abdominal pain
• Severe flank or back pain
• Shock or hemorrhage