Application of laparoscopy combined with cystoscopy for the treatment of elderly patients with intraperitoneal bladder rupture / 中华老年医学杂志

Objective:To examine the overall benefits of laparoscopy combined with cystoscopy for the treatment of elderly patients with intraperitoneal bladder rupture, in order to provide recommendations for establishing the optimal treatment regimen for elderly patients with intraperitoneal bladder rupture.Methods:A retrospective analysis was conducted, with clinical data of 31 elderly patients with intraperitoneal bladder rupture(Group A)who received laparoscopic repair at our hospital between July 2017 and March 2020.Group B included 32 elderly patients with intraperitoneal bladder rupture who received repair with laparoscopy combined with cystoscopy during the same period at our hospital.Complete medical records, treatment data and examination data of all patients were available for analysis.Results from perioperative indexes, including activities of daily living(ADL)scores before the procedure and after the follow-up and postoperative complications, were compared between the two groups.Results:Compared with Group A, Group B had a shorter total operation time(106.5±10.2)min vs.(123.3±10.4)min and a shorter hospitalization time(6.2±1.4)d vs.(8.7±1.6)d, with statistically significant differences( t=6.444 and 6.583, P<0.001). The amount of bleeding[46.4(46.4~47.5)]ml vs.[45.7(41.3~47.5)ml, U=1.905, P=0.057], time to first passage of flatus[(2.4±1.1)h vs.(2.7±1.1)h, t=0.874, P=0.386]and time to drainage tube removal[(4.2±0.8)d vs.(4.3±0.8)d, t=0.619, P=0.539]showed no statistically significant differences between the two groups.Group B had a preoperative ADL score of 52.3(51.9, 53.3)and a post-follow-up score of 75.9(75.3, 76.4), while Group A had a pre-operative score of 52.2(51.2, 53.2)and a post-follow-up score of 65.6(64.6, 68.8). At the end of the follow-up, ADL scores of both groups were higher than those before the procedure(Group B: Z=6.832, Group A: Z=6.769, P<0.01), but ADL scores in Group B were higher than in Group A, with statistical significance( Z=6.653, P<0.001); The two groups had no statistical difference in total incidence of complications(12.50% vs.16.12%, χ2=0.003, P=0.959). Conclusions:Compared with laparoscopy alone, laparoscopy combined with cystoscopy can shorten the operation time and promote postoperative rehabilitation for the treatment of elderly patients with intraperitoneal bladder rupture and improve activities of daily living of patients, without increasing the risk of complications, indicating good safety.

Spontaneous rupture of neurogenic bladder

Pneumoperitoneum is abnormal presence of air or any other gas in the peritoneal cavity. This finding can be both benign or a sign of a grave underlying pathology and a wide spectrum of clinical conditions can attribute to the finding. Prompt clinical examination of a case of abdominal pain can identify findings of peritonitis. We are reporting an interesting case report about a patient of acute abdomen with pneumoperitoneum and peritonitis which was caused by spontaneous rupture of urinary bladder. A 36-year-old male, came with complaints of abdominal pain for one day, two episodes of non-bilious vomiting. He was a known case of neurogenic bladder on continuous bladder drainage. Systemic examination of the abdomen showed warmth, diffuse tenderness, guarding and absent bowel sounds. Bladder catheterisation showed clear urine. On investigation, He had pneumoperitoneum in chest X-ray and free fluid in ultrasonography. A clinical diagnosis of hollow viscus perforation was made and emergency laparotomy was done in view of signs of peritonitis. There was rupture of the dome of urinary bladder with necrosis of the bladder wall and extravasation of urine into the peritoneal cavity. This rare presentation should remind us to keep all the differential diagnoses in mind while opening a case of perforation peritonitis as timely intervention can well and truly be the difference between life and death.

Postpartum spontaneous bladder rupture

Spontaneous bladder rupture after normal vaginal delivery is a rare complication. Patients may present with abdominal distention, fever, haematuria, oliguria and deranged KFT (kidney function test). We are reporting two cases of primigravida with postpartum bladder rupture, one case was diagnosed at laparotomy and the other preoperatively. A patient who presents with retention of urine, haematuria ascites and deranged KFT after uneventful normal vaginal delivery, spontaneous bladder rupture should be suspected. Early diagnosis and management can decrease the morbidity.

Management of abdominal compartment syndrome after transurethral resection of the prostate / Manejo da síndrome do compartimento abdominal pós-ressecção transuretral de próstata

Acute abdominal compartment syndrome is most commonly associated with blunt abdominal trauma, although it has been seen after ruptured abdominal aortic aneurysm, liver transplantation, pancreatitis, and massive volume resuscitation. Acute abdominal compartment syndrome develops once the intra-abdominal pressure increases to 20-25 mm Hg and is characterized by an increase in airway pressures, inadequate ventilation and oxygenation, altered renal function, and hemodynamic instability. This case report details the development of acute abdominal compartment syndrome during transurethral resection of the prostate with extra- and intraperitoneal bladder rupture under general anesthesia. The first signs of acute abdominal compartment syndrome in this patient were high peak airway pressures and difficulty delivering tidal volumes. Management of the compartment syndrome included re-intubation, emergent exploratory laparotomy, and drainage of irrigation fluid. Difficulty with ventilation should alert the anesthesiologist to consider abdominal compartment syndrome high in the list of differential diagnoses during any endoscopic bladder or bowel case.

A síndrome compartimental abdominal aguda é mais comumente associada a trauma abdominal fechado, embora tenha sido observada após ruptura de aneurisma da aorta abdominal, transplante de fígado, pancreatite e reanimação com volume maciço. A síndrome compartimental abdominal aguda surge quando a pressão intra-abdominal aumenta para 20-25 mm Hg e é caracterizada pelo aumento das pressões das vias aéreas, ventilação e oxigenação inadequadas, função renal alterada e instabilidade hemodinâmica. Este relato de caso descreve o desenvolvimento da síndrome compartimental abdominal aguda durante a ressecção transuretral de próstata com ruptura da bexiga extra e intraperitoneal sob anestesia geral. Os primeiros sinais da síndrome compartimental abdominal aguda nesse paciente eram pressões de pico elevadas das vias aéreas e dificuldade para fornecer volumes correntes. O manejo da síndrome de compartimento inclui reintubação, laparotomia exploratória de emergência e drenagem de líquidos de irrigação. A dificuldade na ventilação deve alertar o anestesiologista para que considere a síndrome compartimental abdominal em primeiro lugar na lista de diagnósticos diferenciais durante qualquer caso de endoscopia de bexiga ou intestino.

Treatment of intraperitoneal bladder rupture:a comparative study between laparoscopic and open surgery / 临床外科杂志

Objective To compare the clinical efficacy of laparoscopic surgery and open surgery for intraperitoneal bladder rupture.Methods From January 2004 to August 2013,the clinical data and therapeutic methods of 50 patients with intraperitoneal bladder rupture were retrospectively reviewed,inclu-ding 26 cases of laparoscopic surgery and 24 cases of open surgery.The operative time,intraoperative blood loss,postoperative intestinal recovery,hospital stay,analgesic use rate and complication ratio were com-pared between the two groups.Results All surgeries were successfully performed.There were significant differences in intraoperative blood loss [(54.24 ±5.38)ml vs(89.35 ±12.17)ml],intestinal recovery time [(23.24 ±2.39)h vs(38.42 ±6.98)h],hospital stay [(4.64 ±1.42)d vs(7.04 ±1.29)d]and analgesic use rate [38.64%(10 /26)vs 75.00%(18 /24)]between laparoscopy group and open surgery group,respectively(P 0.05).Conclusion Laparoscopic treatment of intraperitoneal bladder rupture has the advantages of mini-invasion and rapid re-covery compared with traditional open surgery.

Ruptura de bexiga em um cão: relato de caso / Bladder rupture in a dog: case report

A ruptura de bexiga é uma das anomalias do trato urinário mais recorrente nos cães e nos gatos, e pode ser causada por diferentes fatores, como trauma, necrose ou alguma complicação durante uma cirurgia vesical. Como conseqüência, ocorre o uroperitônio que, em longo prazo, leva à uremia, desidratação, hipovolemia, hipercalemia e morte (FOSSUM, 2008). O objetivo deste trabalho é relatar um caso clínico-cirúrgico de uma ruptura de bexiga em um cão da raça Fila Alemão.

Pelvic Bone Fracture with Bladder Rupture / 대한정형외과학회잡지

PURPOSE: The purpose of this study was to evaluate the injury mechanism of pelvic bone fracture and injury type and treatment of bladder rupture associated with pelvic bone fracture. MATERIALS AND METHODS: From September 2002 to February 2011, we treated pelvic bone fracture with bladder rupture in 56 cases with minimal follow up of one year. Each of the 56 cases was classified into groups depending on the mechanism of pelvic fracture (Young classification) and the aspect of bladder rupture (intraperitoneal rupture, extraperitoneal rupture, combined rupture) after which the relationship between the two aspects was analyzed retrospectively. RESULTS: There were a total of 56 cases where bladder ruptures occurred in association with pelvic bone fractures; 34 patients were men and 22 patients were women. The average age was 58.2 years (range: 19-84). Traffic accidents were the main cause of pelvic bone fractures with bladder ruptures in 41 cases. The main injury mechanism was lateral compression, and pubic ramus fractures occurred in 38 cases (67.9%). Regarding the classifications of bladder ruptures, there were 17 cases of intraperitoneal rupture, 37 cases of extraperitoneal rupture, and two cases of combined rupture. Operations were performed on all cases of intraperitoneal and combined rupture and on six cases of extraperitoneal rupture. CONCLUSION: Lateral compression was the most common injury of bladder rupture in pelvic bone fracture. Bladder ruptures occurred even in cases where the displacement of pelvic bones was not severe and also in cases of low energy injury.

Emergency treatment of pelvic fracture complicated with traumatic rupture of urethra and bladder / 中国综合临床

ObjectiveTo investigate emergency diagnosis and treatment of pelvic fracture complicated with traumatic rupture of urethra and bladder,and to improve the success rate of treatment on pelvic fracture.MethodsClinical data of 52 cases of pelvic fracture complicated with traumatic rupture of urethra and bladder in department of emergency and urology from 2000 to 2010 was retrospectively analyzed.Results Among the 52 patients,there was 41 cases of pelvic fracture complicated with posterior urethral disruption,15 cases complicated with rupture of bladder and 4 cases complicated withtraumatic rupture of urethra and bladder at the same time.In 41 cases with posterior urethral rupture,6 individual's condition were relatively so severe that they onlyunderwent bladder puncture nephrostomy,and 29 cases underwent traction urethral realignment,the other 6 cases didn't undergo surgery; In 15 cases of patients with bladder rupture,2 patients were performed urethral realignment and bladder repair,11 patients underwent the bladder repair only and the other 2 patients were not performed surgery.There were 8 patients died and the mortality rate was 15.4％.Six died cases failed to conduct emergency surgery because of uncontrollable bleeding and another 2 cases died due to multiple organ failure.ConclusionPelvic fractures is a disease with more complications,it should be diagnosed as early as possible.Patients invalid for conventional anti-shock should be performed pelvic external fixation and emergency embolization to stop bleeding in the emergency department,and undergo associated processing after they are in stable condition.

A Case of Peritonitis Induced by Urinary Ascites Due to Spontaneous Intraperitoneal Bladder Rupture

It is rare to find spontaneous intraperitoneal bladder rupture cases, and they usually have causes such as bladder tumors, tuberculosis, prolonged cystitis, diverticulum, calculus, urethral obstruction, long term placement of an indwelling urethral catheter, and so on. A very few cases have been reported which occurred after drinking alcohol without any organic bladder problems, and its causal relationship has yet to be defined. Recently, a 66-year-old female visited the emergency room. She drank the day before and suddenly had pain in her lower abdomen and dysuria at dawn. Gross hematuria, ascites, and peritoneal irritation signs were observed. Paracentesis was performed, and the ascites examination showed an increase of the creatinine level. After retrograde cystography, it was diagnosed as spontaneous intraperitoneal bladder rupture, and a laparoscopic suture repair was performed. She progressed favorably and went home.

Cistitis eosinofílica: ruptura vesical espontánea recurrente en un adulto / Eosinophilic cystitis: recurrent spontaneous bladder rupture in an adult

Introducción: La cistitis eosinofílica descrita por primera vez en 1960 por Brown, corresponde a una patología inflamatoria de la vejiga muy infrecuente, de etiología específica aún incierta. Puede variar desde inflamación moderada, hasta vejiga fibrótica con dilatación pielocalicilar y grados variables de insuficiencia renal. Si bien, tiene una presentación clínica variable, no se ha descrito previamente en la literatura la perforación vesical espontánea recurrente. Caso clínico: Presentamos el caso de una mujer de 35años con historia de hematuria, poliquiuria, tres perforaciones vesicales espontáneas y microvejiga fibrótica con hidroureteronefrosis bilateral que se maneja finalmente con ampliación vesical con segmento de íleon y además, exponemos una revisión actualizada de la literatura. Conclusión: La cistitis eosinofílica es una entidad de etiología incierta, con una historia natural impredecible. Su incidencia y prevalencia son desconocidas y si bien, no ha sido descrita previamente en un adulto en nuestro medio, es recomendable considerarla entre los diagnósticos diferenciales de una hematuria macroscópica o síndrome de irritación vesical persistente. La ruptura vesical espontánea recurrente es una presentación clínica no descrita previamente en la literatura. Se deben continuar periódicamente controles imagenológicos y de laboratorio y su tratamiento aún no está estandarizado.

Introduction: Eosinophilic cystitis was first described in 1960 by Brown, it is an inflammatory disease of the bladder that is extremely rare where etiology remains uncertain. It ranges from a mild inflammation to a fibrotic bladder with pielocalycilar dilatation and varying degrees of renal failure. While it has a variable clinical presentation, recurrent spontaneous bladder perforation has not been described previously in the literature. Case report: We report the case of a 35 years old women with a history of hematuria, polyaquiuria, three spontaneous bladder perforations and fibrotic microbladder with bilateral hydroureteronephrosis that is finally managed by bladder augmentation made of an ileum segment. Additionally, we present an updated revision of the literature. Conclusion: Eosinophilic cystitis is an entity of unknown etiology with an unpredictable evolution. Incidence and prevalence are unknown and although it has not been previously reported in our adult patients, it should be considered as differential diagnosis of gross hematuria or persistent bladder irritation syndrome. Recurrent spontaneous bladder rupture is a clinical presentation not previously described in the literature. Periodic monitoring and laboratory imaging should be established and treatment is not yet standardized.

Nutrición parenteral post-quirúrgica en un paciente canino sometido a corrección de ruptura vesical. Reporte de un caso / Nutrição parenteral pós- cirúrgica num paciente canino submetido a correção de ruptura vesical. Reporte de um caso / Post-surgical parenteral nutrition in a dog whit bladder rupture. A case report

La nutrición parenteral (NP) es la aplicación intravenosa de nutrientes para cubrir los requerimientos nutricionales de un ser vivo. Es utilizada en pacientes que no tienen la vía oral habilitada. En este artículo se presenta un reporte de un canino con ruptura vesical que fue atendido en el Centro de Veterinaria y Zootecnia de la Universidad CES (Medellín, Colombia) la cual se le corrigió quirúrgicamente poniendo un injerto de un fragmento de tejido gástrico. Se aplicó la NP ya que el animal no presentó consumo de alimento por más de 5 días y tenía una pérdida de peso marcada con retraso en la cicatrización y se hacía necesaria una terapia de soporte nutricional. Como complicación se presentó edema del sitio de venopunción al segundo día de aplicación por lo cual se retiró la NP. El edema se resolvió rápidamente sin ninguna otra complicación y con una mejoría notoria del animal. La NP es una excelente herramienta para el soporte clínico de pacientes que no tienen la vía oral habilitada ya que una buena nutrición permite una mejor cicatrización de los tejidos y una mejor inmunocompetencia.

Parenteral nutrition (PN) consists of the application of intravenous nutrients to meet the nutritional requirements of a living being. It is used in patients who do not have the oral route enabled. This paper presents a report of a canine with ruptured bladder that was served at the “Centro de Veterinaria y Zootecnia de la Universidad CES (Medellín, Colombia) which will be corrected surgically placing a graft of a fragment of gastric tissue. NP was applied and that the animal did not provide food consumption by more than 5 days and had lost weight marked with delayed healing and therapy was needed nutritional support. As complication was presented edema venipuncture site on the second day of application for which the NP withdrew. The swelling was resolved quickly without any complication and with a noticeable improvement of the animal. The NP is an excellent tool for the clinical support of patients who do not have enabled the oral route because good nutrition allows for a better healing of tissues and better immune competence.

A nutrição parenteral (NP) é a aplicação intravenosa de nutrientes para preencher as exigências nutricionais de um ser vivo. É utilizada em pacientes onde a via oral não esta habilitada. Neste artigo se apresenta um reporte de um canino com ruptura vesical que foi atendido no Centro de Veterinária e Zootecnia da Universidade CES (Medellín, Colômbia) a qual foi corrigida cirurgicamente colocando um enxerto de um fragmento de tecido gástrico. Foi aplicada a NP já que o animal não apresentou consumo de alimento por mais de 5 dias, tendo uma marcada perda de peso com atraso na cicatrização sendo necessário realizar uma terapia de suporte nutricional. Como complicação se apresentou um edema no lugar da venopunção ao segundo dia de aplicação pelo que se retirou a NP. O edema foi solucionado rapidamente sem nenhuma outra complicação e com melhoria notória do animal. A NP é uma excelente ferramenta no suporte clínico em pacientes que não têm a via oral habilitada já que uma boa nutrição permite a melhor cicatrização dos tecidos e una maior imunocompetência.

The Sentinel Clot Sign: a Useful CT Finding for the Evaluation of Intraperitoneal Bladder Rupture Following Blunt Trauma

OBJECTIVE: To evaluate the frequency and relevance of the "sentinel clot" sign on CT for patients with traumatic intraperitoneal bladder rupture in a retrospective study. MATERIALS AND METHODS: During a recent 42-month period, 74 consecutive trauma patients (45 men, 29 women; age range, 12-84 years; mean age, 50.8 years) with gross hematuria were examined by the use of intravenous contrast-enhanced CT of the abdomen and pelvis, followed by retrograde cystography. Contrast-enhanced CT scanning was performed by using a helical CT scanner. CT images were retrospectively reviewed in consensus by two radiologists. The CT findings including the sentinel clot sign, pelvic fracture, traumatic injury to other abdominal viscera, and the degree of intraperitoneal free fluid were assessed and statistically analyzed using the two-tailed x2 test. RESULTS: Twenty of the 74 patients had intraperitoneal bladder rupture. The sentinel clot sign was seen for 16 patients (80%) with intraperitoneal bladder rupture and for four patients (7%) without intraperitoneal bladder rupture (p < 0.001). Pelvic fracture was noted in five patients (25%) with intraperitoneal bladder rupture and in 39 patients (72%) without intraperitoneal bladder rupture (p < 0.001). Intraperitoneal free fluid was found in all patients (100%) with intraperitoneal bladder rupture, irrespective of an associated intraabdominal visceral injury, whereas 19 (35%) of the 54 patients without intraperitoneal bladder rupture had intraperitoneal free fluid (p < 0.001). CONCLUSION: Detection and localization of the sentinel clot sign abutting on the bladder dome may improve the accuracy of CT in the diagnosis of traumatic intraperitoneal bladder rupture, especially when the patients present with gross hematuria.

A Death caused by Increased Intraabdominal Pressure due to Spontaneous Intraperitoneal Bladder Rupture / 대한법의학회지

A 45-year-old female with psychosis complained urological symptom of urinary incontinence and voiding difficulty with abdominal pains and expansion during her psychiatric hospitalization and suddenly collapsed at the 14th day of the admission. At autopsy, the urinary bladder showed a focal perforation and the abdominal cavity was filled with massive urinary ascites. The both lower lobes and the right upper lobe of the lung were accompanied by atelectasis. The death mechanism of this case could be explained that an increased abdominal pressure produced by massive uroperitoneum with spontaneous bladder rupture led to respiratory failure. The so-called abdominal compartment syndrome was manifested by massive uroperitoneum and caused a death. This would be the first forensic medical case that an undiagnosed spontaneous bladder rupture resulted in death of a psychiatric illness patient.

Laparoscopic repair of intraperitoneal bladder rupture: A case report

An intraperitoneal bladder rupture due to occupational injury in young male patient was described and treated. For management, the bladder perforated site was sewed endoscopically. Post-operatively, the condition was improved progressively, peritoneal drain was removed after 24 hours and patients was discharged in 8th day after removing urine catheter.

Laparoscopic Repair of Traumatic Intraperitoneal Urinary Bladder Rupture / 대한비뇨기과학회지

The development, over the last 10 years, of laparoscopy has revitalized interest in the minimal invasive technique as a diagnostic tool in trauma cases. Laparoscopy is advocated to lessen the morbidity associated with open procedures. In trauma cases, therapeutic laparoscopy has not been advocated due to potential missed injury, but several authors have reported laparoscopic repairs of simple intra-abdominal injuries. We report a case of intraperitoneal bladder rupture treated with laparoscopy.

Extraperitoneal Bladder Rupture during the Bladder Distension Therapy: A case report

A 75-year-old woman presented a cauda equina syndrome with epiconus involvement from the compression fractures of T12, L1, and L3 vertebrae as a result of fall accident. Cystometrogram performed at three months after the injury showed a small bladder capacity and low compliance. Anticholinergic medications including intravesical instillation of oxybutynin solution failed to increase the bladder capacity or lower the intravesical pressure. Bladder distension therapy using normal saline infusion with a volume surpassing the previous measured maximal bladder capacity was performed. The procedures were repeated four times per day. At the fifth day of the distension therapy, the patient complained of acute low abdominal pain and gross hematuria. The cystogram revealed the extraperitoneal bladder rupture. The patient was treated successfully with antibiotics and continuous urinary drainage through the Foley catheter for 14 days. We report a case of extraperitoneal bladder rupture during the bladder distension therapy.

Contribution to early diagnosis and effective treatment of bladder rupture due to the close abdominal trauma

Study on 69 patients with bladder rupture due to the abdominal trauma (male: 61; ages of 15-62) in Viet Duc hospital during 1993-1997 diagnosed and treated. The results have found that 39 patients diagnosed as bladder rupture and received emegency operation due to the shock and the intraabdominal bleeding. 20 patients diagnosed timely and 10 patients lately diagnosed within 2-9 days. The mortality rate was 17.4% and the complication rate was 56.5%.

The Diagnostic Value and Use of Computerized Tomography in Bladder Rupture / 대한비뇨기과학회지

PURPOSE: We present our experience with computerized tomography (CT) for diag nosing bladder rupture in patients with blunt abdominal and/or pelvic trauma, and compare the results of CT with those of retrograde cystography. MATERIALS AND METHODS: We reviewed 52 consecutive cases diagnosed as bladder rupture at our hospital from September 1993 to June 2000. Of them 25 cases under went retrograde cystography and CT scan simultaneously. After CT scan, post-CT KUB were taken in all cases. Blind readings of CT scans were performed by one radiologist, and the presence or diagnostic accuracy of bladder rupture was evaluated. RESULTS: Of the 25 cases, 21 cases (84%) were accurately diagnosed with CT scan alone. With retrograde cystography, diagnosis was made in 23 cases (92%), and 2 cases had no definite finding of bladder rupture. On post-CT KUB, bowel loop highlighting or perivesical extravasation of contrast media was noted in 20 cases (80%) of 25 cases. This finding also contributed to the diagnosis of bladder rupture and evaluation of upper collecting system. With CT scan, other intra-abdominal injuries were found in 9 cases (36%) and 5 cases of them underwent additional operations. CONCLUSIONS: In patients with bladder rupture, evaluation of intra-abdominal injury or upper urinary tract are impossible with retrograde cystography alone. If CT scan is properly performed with pre and post-CT KUB in the initial evaluation, more accurate diagnosis and immediate surgical repair are possible in combination with retrograde cystography.

Transcutaneous cystostomy with catheter floy by Sai Gon trocar

Nguyen Thanh Nhu has made a modified trocar: The Saigon trocar (patent pending) easy to be made in Vietnam, easy to use, safe, easy to maintenance and sterilisation, used with a 18F Foley catheter. We have performed cystostomies by using the Saigon trocar to put Foley catheters of 18F for 70 patients and by open surgery to put Foley catheters of 22F for 40 patients at Binh Dan hospital and 115 People Hospital in 1999. No operative complication has been recorded for trocar cystostomy: however, 7 failed cases because the procedure has not been carried out properly, had to be switched to open surgery. Using the Saigon trocar to perform suprapublic cystostomy reduces significantly procedure time and post-operative days, therefore the treatment cost is reduced (roughly 500000 VND/case). To prevent from complications, the procedure must be right indicated and done with good care (bladder volume >330ml, puncture perpendicularly to the abdominal wall).

Nonoperative Management of Extraperitoneal Bladder Rupture / 대한비뇨기과학회지

During last two year and seven month, We have seen 38 patients bladder rupture due to 34 blunt trauma, 2 penetrating injuries and 2 iatrogenic causes. There were 13(34.2%) intraperitoneal and 25(65.8%) extraperitoneal injuries. Nonoperative( catheter ) management was used in 21 patients with extraperitoneal rupture of the bladder with extravasation of dye found by retrograde cystogram and successfully treated by urethral catheter drainage only. We excluded 4 patients coexisting urethral rupture and significant intraabdominal injury. Complication occurred in 8 of the 2l patients but all were treated spontaneously during catheter drainage. It seemed obvious that nonoperative management will give a satisfactory result and would not be necessarily benefit from an operation to closing the bladder.