Urinary bladder tamponade

Bladder tamponade is an acute condition in urology in which the entire bladder volume is filled with blood and blood clots. The most common cause is bleeding from bladder cancer (urothelial carcinoma).

Symptoms
The condition is very painful. It is possible to palpate a crowded bladder above the pubic area. The patient is unable to urinate despite strong compulsion. It may be preceded by haematuria. Depending on the size of the blood loss, the development of hemorrhagic shock is also possible. thumb|Schema of an inserted bladder catheter into the bladder - bladder lavage

Diagnosis
The diagnosis is based on the patient's clinical condition. Furthermore, using the endoscopic imaging method - cystoscopy, which definitively confirms the diagnosis. We need to monitor the patient's vital signs - blood pressure, respiratory, and heart rate - to catch the development of shock in time. It is also necessary to take blood for examination (blood count, biochemistry, coagulation parameters).

Treatment
Upon admission, it is necessary to ensure venous access, infusion (or cover blood losses), and drain the bladder. We use a three-way urinary catheter and perform intensive bladder lavage with saline. Due to their size, clots do not leave spontaneously, it is necessary to dissolve them. We will ensure that no further clot is formed by continuous lavage.

The treatment falls entirely within the competence of the urologist. It consists of cystoscopy and stopping of bleeding by electrocoagulation (per urethram). The condition requires further examination of the patient, as the most common cause is bladder cancer.

Related Articles

 * Bladder cancer
 * Bladder catheterization (pediatrics)
 * Insertion of permanent urinary catheter
 * Nursing procedure during catheter insertion