Korean J Urol.  2007 Mar;48(3):327-332. 10.4111/kju.2007.48.3.327.

Comparison of Clinical Characteristics between Intraperitoneal and Extraperitoneal Bladder Rupture

• Chung JM
• Kim JM
• Lee SD

• KMID: 1997133
• DOI: http://doi.org/10.4111/kju.2007.48.3.327

Abstract

PURPOSE
To compare the clinical characteristics between intraperitoneal and extraperitoneal bladder ruptures.
MATERIALS AND METHODS
58 patients with a bladder rupture were divided into group A (34 intraperitoneal rupture) and group B (24 extraperitoneal rupture). The medical records and radiological findings were retrospectively reviewed.
RESULTS
The follow up period in all patients was 5.8 4.5 months (1-20 months). The male to female ratios and the mean ages in groups A and B were 14:3, 17:7 and 43.9+/-14.2, 46.4+/-14.8 years, respectively (p>0.05), with the peak incidence being in the fifth and sixth decades. There were no statistical differences in the urologic symptoms and signs between groups A and B. The common cause of injuries in groups A and B were direct blow (41.3%) and out-car traffic accident (54.1%), respectively (p<0.05). The main associated injuries in groups A and B were pelvic bone fractures or intestinal injuries and pelvic bone fractures, respectively. The treatment modalities were an operation in 32 (94.1%) in group A; all group B cases were conservatively managed. The durations of catheter indwelling were 17.0+/-9.4 and 22.7+/-10.9 days in groups A and B, respectively (p<0.05).
CONCLUSIONS
The bladder rupture occurred commonly in the fifth and sixth decades, especially in males. The most frequent causes of intraperitoneal and extraperitoneal ruptures were a direct blow and a traffic accident, respectively. Pelvic bone fractures were the most common associated injury, especially with extraperitoneal ruptures. In contrast to an extraperitoneal rupture, most intraperitoneal ruptures were managed by operative methods. The duration of catheter indwelling was significantly shorter with intraperitoneal than extraperitoneal ruptures.

Keyword

Bladder; Rupture; Character

MeSH Terms

Accidents, Traffic
Catheters
Female
Follow-Up Studies
Humans
Incidence
Male
Medical Records
Pelvic Bones
Retrospective Studies
Rupture*
Urinary Bladder*

Reference

1. Chung YG. A clinical observations on bladder rupture. Korean J Urol. 1982. 23:1155–1159.

2. Jack W. Walsh PC, Retik AB, Vaughan ED, Wein AJ, editors. Genitourinary trauma. Campbell's urology. 1998. 8th ed. Philadelphia: Saunders;3721–3725.

3. Cass AS. Bladder trauma in the multiple injured patient. J Urol. 1976. 115:667–669.

4. Kwon KS, Kim SK. Clinical observation on bladder rupture. Korean J Urol. 1982. 23:933–936.

5. Gomez RG, Ceballos L, Coburn M, Corriere JN, Dixon CM, Lobel B, et al. Consensus statement on bladder injuries. BJU Int. 2004. 94:27–32.

6. Lee JB, Choi YC, Moon JC, Cho SP. Bladder trauma: is the clinical significance of intraperitoneal and extraperitoneal rupture is not different? J Korean Soc Traumatol. 1997. 10:254–259.

7. Wilkinson FO. Rupture of the posterior urethra with a review of twelve cases. Lancet. 1961. 1:1125–1129.

8. Belis JA, Recht KA, Milam DF. Simultaneous traumatic bladder perforation and disruption of the prostatomembranous urethra. J Urol. 1979. 122:412–414.

9. Kim HC, Shin JH, Lee NK. Nonoperative management of extraperitoneal bladder rupture. Korean J Urol. 1994. 35:1133–1136.

10. Carroll PR, McAninch JW. Major bladder trauma: mechanisms of injury and a unified method of diagnosis and repair. J Urol. 1984. 132:254–257.

11. Reiser C, Nicholas E. Rupture of the bladder: unusual features. J Urol. 1963. 90:53–57.