The treatment for bladder trauma depends on the type of damage.
Blunt injury is damage caused by blows to the bladder. This bruises the bladder.
Penetrating injury is damage caused by something piercing through the bladder. This tears the bladder.
Most of the time, the bladder wall doesn’t tear and is only bruised. The only sign will be bloody urine. Your health care provider may just leave a wide catheter in the bladder so clots can pass. Once the urine becomes clear, the catheter will be taken out if there aren’t any other reasons to leave it in.
If the tear is on the top of the bladder, the hole will usually open to the part of the abdomen that holds the liver, spleen, and bowel. Urine leaking into the abdomen is a serious problem. This tear can be sewn closed with surgery. A catheter is left in the bladder for up to 2 weeks after surgery to allow the bladder to rest. The tube will either come out through the urethra or out through the skin below the belly button.
If the tear is at the bottom or side of the bladder, the urine will leak into the tissues around the bladder instead of the abdominal cavity. Complex injuries of this type should be repaired with surgery. But often it can be treated by simply placing a wide catheter into the bladder to keep it empty. The urine and blood drain into a collection bag. It usually takes at least 10 days for the bladder to heal. The catheter is left in the bladder until an X-ray shows that the leak has sealed. If the catheter doesn’t drain properly, surgery is needed.
Injury to the bladder from a bullet or other penetrating object is usually fixed with surgery. Most of the time, other organs in the area will be injured and need repair as well. After surgery, a catheter is left in the bladder to drain the urine and blood until the bladder heals.