Management Strategies and Surgical Outcomes in Patients with Bladder Injuries Following Trauma

Open Access

Abstract

Background: Bladder trauma is uncommon but can occur after high-energy injuries, especially after road traffic accidents and pelvic fractures, and outcomes often depend on associated polytrauma. The study aims to evaluate the management strategies and surgical outcomes among patients with bladder injuries following trauma. Methods & materials: This observational study was conducted in the Casualty block and Urology Department at Dhaka Medical College Hospital, Bangladesh, from 17 November 2015 to 16 November 2016. Consecutive trauma patients presenting with bladder injury were enrolled. Diagnosis was established based on clinical features, supported by imaging, and confirmed operatively when indicated. Demographic data, injury mechanisms, clinical presentations, associated injuries, and management approaches (operative or conservative) were systematically recorded using a structured form. Early in-hospital complications were documented, and data were analyzed descriptively as frequencies and percentages using SPSS version 26. Results: The majority of patients were young adults aged 21-30 years (39.29%), with a predominance of males (85.71%). Road traffic accidents accounted for the leading mechanism of injury (60.71%). All patients (100%) presented with hematuria and suprapubic abdominal pain. Urinary retention (89.29%), pelvic fracture (78.57%), and hemodynamic instability (64.29%) were also frequently observed. Operative management was required in 82.14% of cases. More than one-third of patients experienced no complications (35.71%). Wound infection was the most common complication (21.43%), while other complications were infrequent. Conclusion: Traumatic bladder injuries mainly affected young men after road traffic accidents, with hematuria and suprapubic pain as universal presentations, often alongside pelvic fracture and urinary retention. Most patients required operative management, and wound infection was the most frequent complication.