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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.