Happy is the one who has never had to rush around in search of a toilet. The overflowing bladder makes itself felt at the most inopportune moment, and after the long-awaited relief the thought creeps in: what if it bursts? Can this happen and under what circumstances?
A bit of anatomy and physiology
The bladder, also called the urea, is located in the pelvis under reliable protection of the pelvic bones. Its main function is the reception, accumulation and timely removal of urine from the kidneys.
The external membrane of the bladder is formed by three layers of smooth muscle tissue, which is very stretched, containing about 500 ml of urine.
The organ's ability to stretch has certain limits, so the logical question arises: can the bladder burst during sleep? When the ureter is full, irritation of the nerve receptors that signal the brain occurs, and the person feels the urge to urinate even in a dream.
In a state of severe alcohol or drug intoxication, when the body loses its ability to reflexively respond to stimuli, in the best case, involuntary emptying occurs. There is embarrassment, and you should not worry about the integrity of the organ, but sometimes excessive pressure provokes a rupture of the bladder wall. However, more often the reasons are not so prosaic and are the result of diseases of the genitourinary system or tragic accident.
What the bladder can burst from
In healthy people, the wall thickness of an empty urine reservoir is 12-15 mm. Even taking into account that when filling muscle tissue stretches to 2-3 mm, one should not worry if the bladder can burst if it is tolerated for a long time: nature provided it with elasticity and a sufficient margin of safety.
Another thing is injuries and diseases, accompanied by inflammation, ulceration, decreased muscle tone and chronic urinary retention. Damage to an overflowing urea can occur in people with cystitis, atony, leukoplakia, and malignant and benign tumors of the bladder.
In fact, organ rupture does not happen often and is the result of external factors:
- injury to a stressed bladder when falling from a height flat or on protruding objects;
- a strong blow to the stomach, for example, when playing sports or in a street fight;
- damage to the fragments of the pelvic bones in severe accidents;
- penetrating wounds in the stomach: stab and gunshot.
Patients who do not trust doctors are worried if the bladder may burst as a result of a medical error? Surgical interventions sometimes cause damage to the bladder, in particular with urethral bougienage or forced emptying.
Like any injury, rupture of the urea has its own characteristics and according to the classification is divided into 2 main types: intraperitoneal and extraperitoneal.
Intraperitoneal rupture
In this case, damage to the bladder occurs in the most vulnerable upper-back. This is an extremely dangerous injury when urine from a crowded damaged organ flows into the peritoneum. The victim experiences a sharp pain in the abdomen, which increases in the supine position.
Increasing persistent pain syndrome, retention of urges when it is impossible to empty, abdominal distention are the main signs of urine getting into the abdominal cavity, therefore, a person with this type of injury requires emergency medical attention.
Extraperitoneal (retroperitoneal) rupture
Can a person’s bladder burst, but he won’t feel it? Yes, if the lower or front walls of the organ are slightly damaged. In this case, urine does not enter the peritoneal cavity, but fills nearby tissues.
The localization of pain in the lower abdomen, bloating and blueness of the skin in the pubic area are considered common for an extraperitoneal rupture. It is worth noting that an extraperitoneal rupture often provokes an injury to the pelvic bones. In this case, the characteristic symptoms will not go unnoticed by traumatologists.
Even if the injury seems not serious and there is no cause for concern, late diagnosis of retroperitoneal rupture can lead to serious complications. Therefore, do not ignore any manifestations of a violation of the integrity of the walls of the bladder.
Burst bladder: main symptoms
Injuries to internal organs are not universal. Their clinical manifestations depend on the severity of the damage, the state of human health, the degree of its pain threshold and other factors. For example, can a bladder burst from an excess of urine in a healthy person? With a strong blow to the stomach, it can, and the case will be classified as a combined rupture of the bladder.
Also, the symptomatology of the pathological state in people with similar injuries varies greatly. Some experience unbearable cutting pain in the lower abdomen, others are dull, paroxysmal. In severe injuries, a shock condition can blur the clinical picture, but the following symptoms are present to one degree or another:
- difficulty, painful urination, with an intraperitoneal rupture of anuria (lack of urine with persistent urges);
- urine turns pink (hematuria);
- tension (hypertonicity) of the abdominal muscles;
- signs of internal bleeding: a sharp drop in pressure, tachycardia (palpitations), pallor, chills, fever.
Do not wonder if the bladder may burst as a result of the injury, you need to urgently send the victim to the hospital. Procrastination can have the most sad consequences.
What happens when the bladder bursts
In many cases, toxins entering the blood and tissues cause inflammation of the internal organs and bones of the pelvis. Even if the victim suffers pain and shock, the likelihood of peritonitis up to a fatal outcome is high.
With minor damage, scarring of muscle tissue passes on its own. However, this takes time, and to do without antibiotics, you need to have very strong immunity.
Therefore, if you suspect a violation of the integrity of the bladder membrane, it is necessary to call an ambulance and to alleviate the condition of the victim.
First aid methods
Before the arrival of doctors, the person must be laid on his back. Under the legs bent at the knees and spread to the sides, put an impromptu roller: a pillow or a folded jacket. The main danger in case of damage to any internal organs is a shock condition. In this case, the legs and pelvis are raised above the head.
If penetrating injury occurs, it is important to stop bleeding and prevent blood poisoning. To do this, the wound is treated with an antiseptic and a bandage is applied.
With internal injuries, cold is locally applied to the stomach, and the victim is covered with a plaid, blanket, outerwear.
It is better to refuse painkillers and hemostatic drugs if possible. So doctors can objectively evaluate the clinical picture and make the correct diagnosis.
Diagnosis and treatment of bladder injuries
A qualified specialist - a surgeon or a traumatologist - will not think about whether the bladder can burst in this patient, but will make a differential diagnosis.
To exclude or confirm the fact of the gap, a number of diagnostic measures are used:
- Ultrasound of the pelvic organs;
- cystography: a hardware study using a radiopaque substance;
- cystoscopy: an endoscopic examination of the bladder cavity.
The methods of modern diagnostics are quite informative and allow you to accurately assess the condition of the bladder and prescribe adequate therapy.
Conservative treatment is indicated for patients with minor extraperitoneal injuries. During therapy, the installation of a urethral catheter and the appointment of a complex of medications, including anti-inflammatory, hemostatic and analgesics, are mandatory.
Surgical intervention is performed in case of serious injuries, when the damaged organ needs to be sutured or removed. Depending on the indications, laparoscopic or abdominal surgery is performed. For the outflow of blood and urine, drainage tubes are installed to the patient, catheterization is performed.
Patients who have suffered injuries of the pelvic organs are recommended to be more attentive to their health. To the question: “If you tolerate, can the bladder burst again?” - the attending physician will unequivocally answer that you should not test the fate and reliability of the urinary system.