A bladder contusion is a bruise to the bladder wall caused by external force. This blunt injury is less severe than a bladder tear or rupture, which involves a complete break.
Understanding Bladder Injury
The bladder is a hollow, muscular organ located in the lower part of the abdomen, primarily protected by the bony pelvis. When empty, its position within the pelvic bones makes it less susceptible to external forces. However, a full bladder expands upward into the abdominal cavity, making it more exposed and vulnerable to injury.
Bladder bruises result from blunt trauma. Common causes include direct impacts to the lower abdomen from falls, sports, or car accidents. Pelvic fractures are often associated with bladder injuries, as bone fragments can bruise or pierce the bladder wall. Deceleration injuries, common in motor vehicle accidents when the bladder is full and a seatbelt is worn, can also cause contusions.
Recognizing Symptoms
Recognizing symptoms is important for seeking medical attention. A common indicator is blood in the urine, known as hematuria. This may appear as faint pink, red, or brownish discoloration, and can be the only noticeable sign of a bladder contusion.
Individuals may also experience lower abdominal pain or tenderness, often localized above the pubic bone. Other urinary symptoms include a frequent urge to urinate, difficulty starting urination, or pain while urinating. An inability to fully empty the bladder or a weak urine stream may also occur.
Seeking Care and Recovery
If a bladder injury is suspected, prompt medical evaluation is important. You should seek emergency medical care if symptoms worsen, if there is severe abdominal pain, or if signs of shock develop, such as decreased alertness, a rapid heart rate, or pale, cool skin. A medical professional will perform a physical examination and may order laboratory tests, including a urinalysis, to check for blood in the urine.
Diagnostic imaging tests, such as CT scans or cystograms, are used to assess the injury’s extent and rule out severe conditions like bladder ruptures. A cystogram involves filling the bladder with contrast dye to visualize its structure and identify leakage. For a bladder bruise, treatment involves supportive measures.
Minor bladder contusions heal on their own with rest and pain management. In some cases, a catheter may be inserted into the urethra for several days to continuously drain urine. This keeps the bladder empty, promoting healing and preventing complications like blood clot retention. Surgical intervention is not necessary for a simple bladder bruise, but is reserved for more extensive injuries like tears or ruptures. Antibiotics may be prescribed to prevent infections during healing.