Definition
A rupture of the bladder is defined as a rupture of the bladder, usually accompanied by urine leaking into the surrounding areas. The medical classification of a ruptured bladder depends on the location of the injury.
Causes
In most cases a rupture of the bladder occurs in connection with a pelvic fracture. Such pelvic fractures usually occur acutely due to an accident. The reason for the rupture of the bladder is due to parts of bone that penetrate the bladder, causing a rupture.
In other cases, however, blunt trauma (for example, a car accident caused by the seat belt or steering wheel) or bruising in the abdominal area can also cause a rupture of the bladder. A spontaneous rupture of the bladder is relatively rare and can occur in patients who have a previous history of bladder rupture due to other conditions in that area. Furthermore, the bladder ruptures when injuries from knives or firearms injure the lower abdomen in the bladder area.
A rupture of the bladder occurs more frequently after an acute injury. People who suffer from a ruptured bladder complain of very severe pain. There are also a number of procedures that the doctor can use to diagnose a ruptured bladder.
Imaging techniques are used for this purpose, which can also show “soft” tissue structures well. For this reason, people suspected of having a ruptured bladder are usually examined and diagnosed with sonography (ultrasound). In special cases, an MRI machine can also be used to confirm the diagnosis, especially if other injuries cannot be ruled out.
Frequency distribution
A total of three different forms of ruptured bladder can be distinguished. A distinction is made here as to where the tear is located in the muscles of the bladder. The bladder is separated from above by the peritoneum from the organs located in the abdominal cavity.
About 25% of bladder tears occur in this area. It is then also called: intraperitoneal rupture of the bladder. This rupture is often caused by a sudden increase in pressure in the lower abdominal area when the bladder is full.
In most cases, however, the rupture of the bladder occurs below this area. If a rupture occurs in the part of the bladder that is not lined with peritoneum, the diagnosis is an extraperitoneal rupture. This injury is a common side effect of a pelvic fracture and accounts for about 70% of all bladder ruptures.
Finally, these bladder ruptures are distinguished from the so-called spontaneous rupture. If the bladder has already been damaged by other diseases, this form of rupture can occur. However, the frequency of this injury is less than 5% of all bladder ruptures.
Symptoms
People with a ruptured bladder generally complain of severe pain in the lower abdomen, which can also radiate to other parts of the body, especially the abdomen. The tear allows blood cells to enter the urine, which show up in red urine when urinating. It is also typical that the affected person is no longer able to hold the urine after a ruptured bladder.
Sensitivity to pressure and pain in the abdominal area are also common symptoms of a ruptured bladder. Typical here is the presence of a so-called “pain of letting go”. This can be tested by pressing the hand deep into the abdomen and then quickly pulling it back.
During the retracting movement, the affected person feels a strong pain. By lightly touching the abdomen, it is usually also possible to determine that the abdomen is very hard, which is related to a tense musculature in this area due to the rupture of the bladder. The therapy of a ruptured bladder depends on where the rupture is located.
If there is an intraperitoneal tear (at the upper part of the bladder), the tear is treated surgically. As soon as the diagnosis has been established, surgery is usually prepared to suture the existing rupture of the bladder. A bladder catheter is then inserted, which should initially relieve the pressure on the bladder. If there is an extraperitoneal (in the lower part of the bladder) rupture, the therapy depends strongly on the severity of the injury. If there is a severe rupture of the bladder, this must also be operated on, whereas in the case of a slight rupture the insertion of a bladder catheter is usually sufficient to relieve the bladder.
