Bladder rupture

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Classification according to ICD-10
S37.22 Rupture of the urinary bladder
ICD-10 online (WHO version 2019)

A rupture of the urinary bladder wall is called a bladder rupture . This is usually a result of external trauma , wherein a full bladder faster than an empty bladder ruptures . The contents of the bladder are emptied intraperitoneally (into the abdominal cavity ) or extraperitoneally - usually into the surrounding tissue.

A rupture of the bladder , on the other hand, is the opening of the amniotic sac - as a "spontaneous rupture of the bladder", a sign of the beginning of birth .

Pathogenesis

Intraperitoneal bladder ruptures occur, for example, due to a steering wheel impression in traffic accidents , and extraperitoneal ruptures due to bone splinters as a result of pelvic fractures . Bladder ruptures due to infected urachus cysts are a rarity .

After delivery by caesarean section , a rupture of the bladder can occur in 0.1–5% of cases.

When urine leaks out of the bladder, fluid builds up in the abdominal cavity ( ascites ). From the urine that has leaked into the abdominal cavity, the urinary substances are reabsorbed into the bloodstream (reabsorbed). This is called “pseudo-kidney failure” because the blood creatinine and urea increase even though the kidneys are not working properly.

Symptoms

Symptoms are pelvic pain, bloody urine (macrohematuria) , the urge to urinate that cannot be suppressed (imperative) , difficulty urinating (dysuria) or urinary retention .

Diagnosis

If the creatinine concentration in the ascites is higher than the creatinine concentration in the blood, this indicates an intraperitoneal urine leak, but is not conclusive. To confirm the diagnosis, the bladder is filled with X-ray contrast medium and an X-ray ( computed tomography if possible ) of the abdomen is made. Evidence is the transfer of contrast medium from the bladder into the abdominal cavity.

therapy

Smaller urine leaks can be treated conservatively by relieving the bladder with a urinary catheter . Larger bladder leaks must be treated surgically.

Complications

Complications of bladder rupture are inflammation of the peritoneum (peritonitis) and blood poisoning (urosepsis) .

Individual evidence

  1. ↑ M. Maruschke, HJ Kreutzer, H. Seiter: Bladder rupture due to spontaneous perforation of an infected urachus cyst. In: The Urologist. Ed. A, June 2003, Volume 42, Issue 6, pp. 834-839.
  2. ↑ Chika N. Okafor, Monika Gupta: Quiz Page August 2008: Acute Kidney Injury Post – Cesarean Delivery: Is GFR Reduced? In: American Journal of Kidney Diseases . No. 52 , 2008, p. A37-A39 ( article ).

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