The bladder isn’t injured often. The bones in the pelvis protect it from most outside forces. But the bladder can be injured by blows or piercing objects. Most often these are related to pelvic fracture. Timely evaluation and proper management are critical for the best outcomes.
The bladder is a balloon-shaped organ that stores urine, which is made in the kidneys. It is held in place by pelvic muscles in the lower part of your belly. When it isn't full, the bladder is relaxed. Muscles in the bladder wall allow it to expand as it fills with urine. Nerve signals in your brain let you know that your bladder is getting full. Then you feel the need to go to the bathroom. The brain tells the bladder muscles to squeeze (or "contract"). This forces the urine out of your body through your urethra
The two basic types of damage to the bladder by trauma are bruises and tears.
Blunt injury (a bruise) is damage caused by blows to the bladder. Penetrating injury (a tear) is damage caused by something piercing through the bladder.
Almost everyone who has a blunt injury to the bladder will see blood in the urine. Those with penetrating injury may not actually see bleeding. There may be pain below the belly button, but many times the pain from other injuries makes the bladder pain hard to notice. If there’s a large hole in the bladder and all of the urine leaks into the abdomen, it’s impossible to pass urine. In women, if the injury is severe enough, the vagina may be torn open as well as the bladder. If this happens, urine may leak from the bladder through the vagina. Blood may also come out of the vagina in this case.
Other symptoms may include:
- Hard to start urinating
- Weak urine stream
- Painful urination
- Severe back pain
When the bladder is empty, the bones of the pelvis protect it from blows to the lower abdomen. As it fills, though, the top of the bladder rises into the abdomen where it’s less protected. In children, the pelvic bones aren’t fully developed, so it’s more easily injured than adults. If the pelvis is hit with a force great enough to break the pelvic bones, the bladder may be injured even if it’s empty.
The most common ways the bladder is injured are:
- Car crashes
- Falls from high places
- Heavy object falling on the lower abdomen
You can prevent bladder trauma from a car crash by wearing a seat belt properly. The seat belt should be worn as a lap belt, and not across the belly. During a car crash, passengers with a full bladder wearing a seat belt around the belly may have the force of the crash focus on the full bladder.
The bladder can also be hurt by being pierced from the outside ("penetrating trauma"). Some causes of penetrating trauma are:
- IEDs (improvised explosive devices)
A health care provider diagnoses bladder injury by placing a tube ("catheter") into the bladder and taking a series of X-rays. X-rays of the urethra may be taken before the catheter is put in, to see if it is damaged. Before the X-rays are taken, the bladder is filled with a liquid that will make it visible on the X-rays.
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.
Although surgical need for the repair of bladder is important, but sometime the function of bladder doesn’t get back to its normal state even after the repair, here are the the list of few medicine of homoeopathic medicine which are used in healing process of the bladder and also for minor injuries.
Arnica: Arnica is very effective when it comes to dealing with deep seated bruises. It can also be used to reduce swelling at the site of the injury. Arnica can be used in pill form or applied in the form of a cream. However, arnica should never be used on an open wound where the skin is cut. In the pill form, arnica can also be used to stop internal or external bleeding.
Calendula: Calendula can be used to fasten the healing process. Along with bruises, it can also be used to treat ruptured muscles and tendons. When applied topically, it draws out dirt and prevents infections.
Hypericum: This homeopathic remedy is very useful in treating injuries and wounds that cause nerve damage. It also ensures that a bruise heals from the inside and not only superficially.
Ledum: Wounds that are caused by a sharp object or formed as a result of painful injections or the after effects of an epidural can be treated with Ledum. It promotes the removal of pus and prevents septic infections.
Staphysagria: Staphysagria is used to treat sensitive wounds where the tissue is lacerated. In such cases, the sphincters are also found to be lacerated and stretched due to foreign bodies. Staphysagria can also be used to treat extremely painful wounds.
Phytolacca: This is an excellent remedy for wounds that have a tendency to ulcerate or injuries that cause soreness and can trigger tetanus. Injured fibrous tissue or osseous muscle sheaths can also be treated with phytolacca.
Mag phos: Especially used post operative, when nocturnal Enuresis occurs especially after catheterization or from nervous irritation, the urine is pale, copious.
Bufo: Wounds that cause the area to feel numb and which trigger muscle spasms that leave the patient unable to move the part can be treated with this homeopathic remedy. It can also be used to treat regional hematomas triggered by the rupturing of blood vessels due to the trauma.