What is extraperitoneal bladder perforation?

Extraperitoneal rupture is the most common type of bladder injury, accounting for ~85% (range 80-90%) of cases. It is usually the result of pelvic fractures or penetrating trauma. Cystography reveals a variable path of extravasated contrast material. Treatment is with an indwelling Foley catheter.

Is the bladder extraperitoneal?

In adults, the bladder is located in the anterior pelvis and is enveloped by extraperitoneal fat and connective tissue. It is separated from the pubic symphysis by an anterior prevesical space known as the space of Retzius.

Is the bladder intra or extraperitoneal?

The bladder is an extraperitoneal muscular urine reservoir located anatomically in the pelvic space behind the pubic symphysis. The proximity to bony structures of the pelvis predisposes this organ to injury. Most injuries are seen at the dome of the bladder, which is its weakest part.

What are symptoms of extraperitoneal bladder rupture?

Classic signs and symptoms of a bladder injury following blunt trauma include gross hematuria; suprapubic pain; extravasation of urine into the perineum, scrotum, and thighs; and lower abdominal bruising.

When do you fix extraperitoneal bladder injury?

Extraperitoneal ruptures that do not heal after four weeks of catheter drainage should be considered for surgical repair. Complicated extraperitoneal bladder ruptures, such as those associated with bone fragments within the bladder and those associated with vaginal or rectal injuries, often require operative repair.

Can your bladder repair itself?

The bladder is a master at self-repair. When damaged by infection or injury, the organ can mend itself quickly, calling upon specialized cells in its lining to repair tissue and restore a barrier against harmful materials concentrated in urine.

When do you fix Extraperitoneal bladder injury?

Can your bladder explode if you don’t pee?

In rare and serious situations, holding urine for too long can lead to a bladder rupture. “We have seen patients who haven’t urinated in about a week, and they’ll have over 2 liters of urine in their bladder,” Dr. Bandukwala says. “If too much pressure builds up in the bladder, it can rupture.

Can you push a prolapsed bladder back into place?

If you or your child has a rectal prolapse, you may be able to push the prolapse back into place as soon as it occurs.

How do you tell if your bladder is damaged?

Symptoms

1. Lower abdominal pain.
2. Abdominal tenderness.
3. Bruising at the site of injury.
4. Blood in the urine.
5. Bloody urethral discharge.
6. Difficulty beginning to urinate or inability to empty the bladder.
7. Leakage of urine.
8. Painful urination.

How is extraperitoneal extravasation used in bladder surgery?

Extraperitoneal Extravasation. In cases where surgical exploration for other injuries is pursued, minor extraperitoneal leaks can be repaired, as well. This facilitates more rapid healing and decreases the potential for complications, as well as the necessary duration of indwelling catheter use in many cases.

Which is the best description of active extravasation?

Active extravasation refers to administered contrast agent that has escaped from injured arteries, veins, bowel, or urinary tract. Similar concepts apply to all types of extravasation, but herein we focus on vascular extravasation. Active extravasation is seen in a minority of trauma patients in whom CT reveals a hematoma in the abdomen or pelvis.

What kind of contrast is used in extraperitoneal rupture Type 4?

In extraperitoneal rupture (type 4), the path of extravasated contrast material is variable: Extravasation is confined to the perivesical space in simple extraperitoneal ruptures, whereas in complex extraperitoneal ruptures, contrast material extends beyond the perivesical space and may dissect into a variety of fascial planes and spaces.

What does active extravasation mean in polytrauma patients?

The presence of active extravasation is an important indicator for morbidity and mortality in polytrauma patients because it denotes significant vessel or organ injury. Active extravasation refers to administered contrast agent that has escaped from injured arteries, veins, bowel, or urinary tract.