The bladder is a muscular organ that stores urine. It is normally protected from injury by the bones in the pelvis, but when full it extends into the abdomen, making it susceptible to injury. Traumatic injuries that break the pelvis can also break the bladder. Bladder ruptures can lead to urine leaking out of the bladder and may heal on their own or require surgery.
When the bladder is ruptured, MedlinePlus explains, it can cause a number of symptoms that can cause physicians to suspect a diagnosis of a ruptured bladder. Patients may have severe abdominal and pelvic pain. Often the patient will also have blood in the urine and urination will be difficult and painful. Dehydration is also possible due to loss of fluids.
One type of test that can be done to diagnose a ruptured bladder is a retrograde cystography, according to the Ohio State Radiology Department. With this test a catheter is inserted into the bladder and a liquid contrasting agent is injected into the bladder. This contrast is visible on an x-ray, and if the bladder is ruptured, the liquid is seen spilling out of the organ. CT scans can also be used to diagnose a bladder rupture.
There are two main types of broken bladder, UrologyHealth explains. An intraperitoneal rupture typically occurs at the top of the bladder. This type of injury will usually cause urine to seep into the abdominal cavity, which is where the rest of the organs in the abdomen are held. A extraperitoneal rupture, on the other hand, typically occurs on the bottom or on the side of the bladder. An injury of this sort typically causes urine to leak into the tissue around the bladder but not into the abdominal cavity.
The type of bladder injury dictates how the broken bladder is treated. Small extraperitoneal ruptures can be treated by placing a large catheter in the bladder that will drain all urine and blood from the bladder while the wound heals. If the hole in the bladder is large or does not heal with this treatment, surgery to repair the hole is necessary. Intraperitoneal ruptures, on the other hand, require surgical repair.
Although a diagnosis of a broken bladder can be daunting, most patients regain normal bladder function within a few weeks, UrologyHealth explains. Antibiotics are often given to prevent infections from developing. In some cases patients may have an overactive bladder for a few months, which is a result of inflammation of the bladder lining. This can be treated with medications until the condition resolves.