The incidence, spectrum and outcomes of traumatic bladder injuries within the Pietermaritzburg Metropolitan Trauma Service

Combined intra- and extraperitoneal urinary bladder rupture – a rare seat-belt injury: A case report

“…Due to its location deep in the bony pelvis the urinary bladder is well protected against external forces [2] . For this reason TBR are rare, representing only 0.87–1.6% of all blunt abdominal trauma cases [3] , [4] . The injury mechanisms of TBR are various: a) primary, due to a direct blow to a distended bladder, while there is a direct correlation between bladder distension and the extent of injury [7] , [8] ; b) secondary, due to shearing forces during high-energy blunt abdominal trauma leading to pelvic fracture; c) due to penetrating injuries and d) due to various iatrogenic causes [2] .…”

“…In the presented case the whole-body standard contrast-enhanced CT detected a CBR, so a CT cystography was no longer necessary and surgical treatment was indicated. Surgical repair with absorbable suture is the standard of care in IBR, whereby there is no consent whether two-layer closure is superior to single layer closure in open urinary bladder repair [4] . Depending on the extent of the injury, isolated EBR is managed mainly nonsurgical with urinary catheter drainage for 10 days to 3 weeks [2] .…”

“…As the coexistence of a seat-belt sign and abdominal pain is associated with an increased risk of intraabdominal injuries [17] and considering the high mortality rates of TBR, ranging from 11% to 22% [4] , [18] , an immediate and adequate diagnostic approach followed by an appropriate therapy is indicated, while physicians should maintain a high level of suspicion for urologic injuries following blunt abdominal trauma.…”

“…The urinary bladder is a muscular hollow organ which is well protected against external trauma due to its location deep in the bony pelvis [2] . Hence, traumatic urinary bladder injuries (TBR) are rare, representing only 0.87–1.6% of all blunt abdominal trauma cases [3] , [4] . They usually result from blunt or penetrating trauma.…”

Traumatic renal injury: Five-year experience at a major trauma centre in South Africa

“…The PMTS prospectively collects data for the purpose of research and auditing using a prospective hybrid electronic medical registry (HEMR) [7] . In terms of the urogenital system, traumatic bladder injuries [8] and combined colon and renal injuries [9] have already been described using this registry. The registry was interrogated retrospectively, and all patients diagnosed with a TRI between January 2012 and December 2016 were identified.…”