Trauma or damage to the bladder.

External bladder injury is caused by direct or piercing trauma to the lower abdomen or pelvis. Other causes include examinations by endoscope and laparoscope, and open pelvic surgery.

Symptomatic complications unique to bladder injury include: infection, urinary incontinence, and bladder instability. In addition, hematuria also presents.

History of blunt bladder trauma in the abdominal or pelvis area should be obtained in any patient who presents with hematuria. Other clinical findings include tenderness or distention of the abdomen, pelvic fracture, and inability to void. Radiography with the use of contrast dye (cystography) is used to verify the diagnosis and classify the bladder trauma or injury. Rupture that occurs outside of the peritoneal cavity (extraperitoneal) accounts for most of the major trauma or injury. These ruptures are most frequently associated with pelvic fractures. Intraperitoneal ruptures usually result in bladder distention. Bruises (contusions) usually indicate damage to the bladder wall in the absence of urinary leakage, and may result in displacement of the bladder.

The treatment chosen depends on the form and extent of injury. Extraperitoneal ruptures are usually treated surgically unless they are small. If the rupture is small, or in the case of contusions, drainage with a large catheter may be successful treatment. Intraperitoneal ruptures require immediate surgery.

The mortality rate is approximately 20% depending on the extent of injury.

• None.  

• When evaluating any claim involving loss or loss of use of one or more creative organs, refer to 38 CFR 3.350 of this chapter to determine whether the Veteran may be entitled to special monthly compensation. Footnotes in the schedule indicate conditions which potentially establish entitlement to special monthly compensation; however, there are other conditions in this section which under certain circumstances also establish entitlement to special monthly compensation.