Bladder and ureteric trauma

Abstract

AbstractA case of penetrating ureteric and bladder injury is reported. The principles of management of ureteric and bladder trauma are demonstrated by the tissue loss in this particular case. Emphasis is placed on the early diagnosis and then careful management of the injuries to allow tissue tension-free healing. The importance of anatomical expertise is demonstrated in the blood supply of the ureter. The case discusses the fragile nature of ureteric tissue needing gentle dissection techniques, respectful handling, and fine sutures. Ureter and bladder injuries have to be repaired in a watertight fashion and drained internally and externally. Urine accumulating in the tissue is toxic and can affect the critically ill trauma patient negatively, therefore, adequate drainage for a length of time allowing healing of tissue is essential.