Bladder Injury Repair

What is Bladder Injury Repair

Bladder injury repair is a procedure to close a cut or tear in the bladder. You may have this procedure if:

  • Your bladder was cut during a surgery.
  • You have an injury in your lower abdomen, such as a broken pelvis, especially if you have a history of alcohol abuse.
  • Your bladder suddenly burst due to injury (trauma).

This procedure is often performed as an emergency treatment.

Tell a health care provider about:

  • All medicines you are taking, including vitamins, herbs, eye drops, creams, and over-the-counter medicines.
  • Any allergies you have.
  • Any problems you or family members have had with anesthetic medicines.
  • Any blood disorders you have.
  • Any surgeries you have had.
  • Any medical conditions you have.
  • Whether you are pregnant or may be pregnant.
  • Any bladder problems you have, including:
    • A full bladder.
    • Trouble urinating.
    • Pain and tenderness.
  • Any time you have had to self-catheterize in the past.
  • Any accidents or injuries you have had that may have hurt your lower abdomen.

What are the risks?

Generally, this is a safe procedure. However, problems may occur, including:

  • Urinary tract infection.
  • Severe bleeding (hemorrhage).
  • Allergic reactions to medicines or dyes.
  • Damage to other structures or organs.
  • Blockage in a ureter. Ureters are the parts of the body that drain urine from the kidneys to the bladder.
  • Pain.

What happens before the procedure?

Medicine

  • Ask your health care provider about:
    • Changing or stopping your regular medicines. This is especially important if you are taking diabetes medicines or blood thinners.
    • Taking medicines such as aspirin and ibuprofen. These medicines can thin your blood.Do not take these medicines unless your health care provider tells you to take them.
    • Taking over-the-counter medicines, vitamins, herbs, and supplements.
  • You may be given an antibiotic medicine to help prevent infection.

Staying hydrated

Follow instructions from your health care provider about hydration, which may include:

  • Up to 2 hours before the procedure – you may continue to drink clear liquids, such as water, clear fruit juice, black coffee, and plain tea.

Eating and drinking restrictions

Follow instructions from your health care provider about eating or drinking restrictions:

  • 8 hours before the procedure – stop eating heavy meals or foods such as meat, fried foods, or fatty foods.
  • 6 hours before the procedure – stop eating light meals or foods, such as toast or cereal.
  • 6 hours before the procedure – stop drinking milk or drinks that contain milk.
  • 2 hours before the procedure – stop drinking clear liquids.

General instructions

  • You may have a small, thin tube (catheter) placed in the part of your body that drains urine from your bladder (urethra). This catheter will drain your urine during and after the procedure (urinary catheter).
  • You may have tests, such as a CT cystogram. This involves injecting dye into the bladder and then doing a CT scan of the bladder. Dye may also be used to check whether your ureters have been injured.
  • You will have a blood test and a urine test.
  • Ask your health care provider how your surgical site will be marked or identified.
  • Plan to have someone take you home from the hospital or clinic.

Plan to have a responsible adult care for you for at least 24 hours after you leave the hospital or clinic. This is important.

What happens during the procedure?

  • To lower your risk of infection:
    • Your health care team will wash or sanitize their hands.
    • Hair may be removed from the surgical area.
    • Your skin will be washed with soap.
  • An IV will be inserted into one of your veins.
  • You will be given one or more of the following:
    • A medicine to numb the area (local anesthetic).
    • A medicine to make you fall asleep (general anesthetic).
  • An incision will be made in your abdomen.
  • Bladder cuts and tears will be closed using absorbable stitches (sutures).
  • Drainage tubes may be placed near your incision to drain any excess fluid from the surgical area (pelvic drain).
  • A urinary catheter may be inserted. This may be inserted if you do not have one yet, or if you have one but need another one.
  • The incision will be closed with sutures and covered with a bandage (dressing).

The procedure may vary among health care providers and hospitals.

What happens after the procedure?

  • You will need to stay in the hospital to recover. Ask your health care provider how long you can expect to stay.
  • Your blood pressure, heart rate, breathing rate, and blood oxygen level will be monitored until the medicines you were given have worn off.
  • You may be given antibiotics to help prevent infection.

Summary

  • Bladder injury repair is a procedure to close a cut or tear in the bladder. This is often an emergency procedure.
  • Risks of this procedure include urinary tract infection, bleeding, allergic reactions, and a blockage in a part of the body that drains urine from the kidneys to the bladder (ureter).
  • After the procedure, you will have a urinary catheter draining your urine, and a pelvic drain to drain excess fluid from the surgical area.

Bladder Injury Repair, Care After

What can I expect after the procedure?

After the procedure, it is common to have:

  • An overactive bladder. This means you may urinate more than normal, have strong urges to urinate, and have urine leaks. These problems may last for a few weeks up to a few months.
  • Some incision pain.
  • An ache in your abdomen.

You may also have:

  • A urinary catheter in place. This is a small, thin tube placed in the part of your body that drains urine from your bladder (urethra). The catheter will be removed after your health care provider determines that your bladder has healed. The healing may take 10 or more days, and you will stay in the hospital during that time.
  • A pelvic drain in place for several days. This is a tube placed near your incision to drain excess fluid from the surgical area.
  • Tests, such as a CT cystogram before the urinary catheter is removed. This may be done to make sure your bladder has healed. This involves injecting dye into the bladder and then doing a CT scan of the bladder.

Follow these instructions at home:

Medicines

  • Take over-the-counter and prescription medicines only as told by your health care provider.
  • If you were prescribed an antibiotic medicine, take it as told by your health care provider.Do notstop taking the antibiotic even if you start to feel better.

Activity

  • Do notdrive or use heavy machinery while taking prescription pain medicine.
  • Limit your physical activity as told by your health care provider. Ask what activities are safe for you. Your health care provider may recommend that you:
    • Do not lift anything that is heavier than 25 lb (11 kg) for up to 3 months.
    • Do not do any exercise besides walking for 3 months.

Incision care

  • Follow instructions from your health care provider about how to take care of your incision. Make sure you:
    • Wash your hands with soap and water before you change your bandage (dressing). If soap and water are not available, use hand sanitizer.
    • Change your dressing as told by your health care provider.
    • Leave stitches (sutures), skin glue, or adhesive strips in place. These skin closures may need to stay in place for 2 weeks or longer. If adhesive strip edges start to loosen and curl up, you may trim the loose edges. Do notremove adhesive strips completely unless your health care provider tells you to do that.
  • Check your incision area every day for signs of infection. Check for:
    • Redness, swelling, or more pain.
    • Fluid or blood.
    • Warmth.

Pus or a bad smell.

General instructions

  • To prevent or treat constipation while you are taking prescription pain medicine, your health care provider may recommend that you:
    • Drink enough fluid to keep your urine pale yellow.
    • Take over-the-counter or prescription medicines.
    • Eat foods that are high in fiber, such as fresh fruits and vegetables, whole grains, and beans.

Limit foods that are high in fat and processed sugars, such as fried and sweet foods.

  • Do nottake baths, swim, or use a hot tub until your health care provider approves. Ask your health care provider if you may take showers. You may only be allowed to take sponge baths.
  • Keep all follow-up visits as told by your health care provider. This is important.

Contact a health care provider if:

  • You do not produce as much urine as you normally do.
  • You have a fever or chills.
  • You have severe pain:
    • In your abdomen.
    • In your back.
  • You have trouble emptying your bladder completely.
  • Your urine is cloudy or bloody.
  • Your urine has an unusual smell.
  • Your sutures fall out too soon.
  • You have redness, swelling, or more pain around your incision.
  • You have fluid or blood coming from your incision.
  • Your incision feels warm to the touch.
  • You have pus or a bad smell coming from your incision.

Get help right away if:

  • You are less alert and more drowsy than usual.
  • You have a fast heart rate.
  • Your skin gets pale or gray, and you are sweating.
  • You have swelling or pain in your legs.
  • You have shortness of breath.
  • You have chest pain.

Summary

  • Keep all follow-up visits as told by your health care provider. This is important.
  • Take over-the-counter and prescription medicines only as told by your health care provider.
  • Contact your healthcare provider if you have severe pain in your abdomen or your back.
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