Extraperitoneal Bladder Rupture Research Articles

The Use of Prolonged Bladder Distension in the Treatment of Intractable Urinary Incontinence in Females with Detrusor Instability

Fifty patients suffering from detrusor instability who failed to respond to anticholinergic treatment were treated with prolonged bladder distension. Twelve months after treatment 9 were symptom free, 15 improved and 26 remained symptomatically unchanged. Extraperitoneal bladder rupture occurred in 2 patients.

Bladder injury in blunt pelvic trauma.

Clinical and radiologic findings in 97 patients with bladder injury secondary to blunt pelvic trauma were reviewed. Fifty-five patients had extraperitoneal bladder rupture; 35, intraperitoneal rupture; two, interstitial bladder injury; and five, combined intraperitoneal and extraperitoneal bladder rupture. Of the 61 of 97 patients with film studies available for review, two patients with surgically proved intraperitoneal rupture had false-negative cystograms. In two other cases of intraperitoneal rupture, the diagnosis was established with cystography but was not demonstrated with urography. All cases of extraperitoneal rupture were demonstrated cystographically; in 15 cases in this group, the injury was complex, with extravasation of contrast material beyond the confines of the perivesical space. In two additional patients, incomplete bladder injury termed "interstitial bladder rupture" was identified. A classification of bladder injury based on cystographic patterns of extravasation is proposed.

Diagnosis and Initial Management of Urological Injuries Associated with 200 Consecutive Pelvic Fractures

AbstractDuring 26 months 200 consecutive patients with fracture of the bony pelvis were evaluated and treated for urological injury. There was no correlation between the extent of pelvic injury and degree of hematuria but hematuria was present in all patients with a urological injury. All urological injuries occurred with anterior arch fractures. The over-all incidence of injury was 13.5 per cent (bladder 9 per cent, urethra 3.5 per cent and combined 1 per cent). Limited extraperitoneal bladder ruptures were treated successfully by Foley catheter drainage.

Traumatische harnblasenperforation bei beckenringfraktur kasuistik mit differential diagnostischen aspekten

In the context to multiple traumata, a 19-year-old man suffered an extraperitoneal bladder rupture due to perforation by a fractured pubic ramus. Because of a rapid shock-induced decrease of hematuria and the misinterpretation of a bruise on the right flank as a renal contusion, the clinical diagnosis was not established. The patient died of head injuries and ruptures of the liver and diaphragm with hemothorax and intra-abdominal bleeding. The impressive bladder perforation was first documented at the postmortem examination. The diagnosis and differential diagnosis of hematuria are discussed.

Rupture of the Bladder following Blunt Trauma

Thirty-four cases of rupture of the bladder due to blunt trauma of the abdomen are reviewed. Intraperitoneal rupture occurred in 41% of the patients: extraperitoneal rupture occurred in 59% of them. Thirty-five per cent of the patients with extraperitoneal bladder rupture sustained concomitant intraperitoneal visceral injuries. While repairing the extraperitoneal bladder rupture a routine laparotomy through a small incision over the linea semicircularis was helpful in discovering intraperitoneal injuries in patients previously assessed by the general surgery service and considered to be free of intraperitoneal pathology.

Elevated Blood Urea Nitrogen: An Aid to the Diagnosis of Intraperitoneal Rupture of the Bladder

A retrospective analysis was done on 18 patients with bladder rupture. At the time of hospitalization 9 patients with extraperitoneal rupture had an average blood urea nitrogen of 14.2 ± 2.2mg. per cent, which did not vary from the normal laboratory value of 14.5 ± 7.4mg. per cent, and 9 patients with intraperitoneal rupture had an average blood urea nitrogen of 29.9 ± 7.6mg. per cent, which was significantly different (p <0.0001) from the discharge blood urea nitrogen (12.9 ± 2.2mg. per cent) and the normal laboratory value. The 2 groups of patients were comparable since no significant difference was found in age, sex, mode of injury, hematocrit value or associated injuries. To quantify the significance of our observation an experimental study was done on dogs with 1) surgically created intraperitoneal bladder ruptures, 2) intraperitoneal injections of urine, 3) intraperitoneal injections of blood and 4) a control group. A sequential increase in serum blood urea nitrogen was found in dogs with intraperitoneal bladder rupture 1 hour after injury to an empty bladder. An intraperitoneal injection of urine showed that a high blood urea nitrogen could be found as early as a half hour after the injection and that it would be cleared totally between 3 and 6 hours. Serum creatinine levels were not as good indicators of intraperitoneal urine, becoming significantly different from control values later than the blood urea nitrogen. All creatinine levels were within the normal human laboratory value, suggesting a poor and sluggish index of this type of injury.Our study shows that increased blood urea nitrogen is a presenting laboratory finding and a sensitive index in the detection of patients who have sustained intraperitoneal rupture of the bladder. Awareness of this finding may lead to an early diagnosis in otherwise clinically unsuspected cases. This test will not provide for a diagnosis of extraperitoneal bladder ruptures.

Clinical Notes on a Case of Fractured Pelvis Complicated by Extra-Peritoneal Rupture of Bladder

Clinical Notes on a Case of Fractured Pelvis Complicated by Extra-Peritoneal Rupture of Bladder