Causes and outcome of bladder injuries in Durban.

OBJECTIVE

To document our experience with the management of bladder injuries.

DESIGN

A retrospective study.

SETTING

King Edward VIII Hospital in Durban, South Africa.

PATIENTS: One hundred and twenty patients with urinary bladder injuries.

INTERVENTIONS: Patients with intraperitoneal bladder injuries underwent laparotomy whereas those with extraperitoneal bladder injuries were managed non-operatively with a suprapubic catheter.

RESULTS

The patients' median age was 28.5 years and the male to female ratio was 5:1. Sixty injuries were due to firearms, seven to stabs and fifty-three were due to blunt trauma. There were other associated injuries in sixty-six patients while fifty patients had isolated bladder injuries. Ninety-four intraperitoneal injuries were repaired while 26 extraperitoneal injuries were managed conservatively. The mortality rate was fourteen per cent (twenty-four per cent for patients with other associated injuries and two per cent for patients with isolated injuries). The mean hospital stay was 18.65 +/- 23.35 days (13.3 +/- 13.5 for firearms 30.56 +/- 33.39 for blunt injuries and 11.00 +/- 2.55 for stabs).

CONCLUSION

The majority of bladder injuries were penetrating and the major cause was firearm wounds. Blunt injuries were associated with prolonged hospital stay. Isolated bladder injuries carried a low mortality rate even in patients with delayed diagnosis. Associated injuries were responsible for the high mortality. Suprapubic cystostomy for extraperitoneal bladder injuries led to no complications in our hands.