Urinary Bladder Tamponade

From WikiLectures

Urinary bladder tamponade is an acute emergency in urology. Bladder is full of heavy blood clot formations. The most often cause is bleeding from bladder carcinoma (urothelial carcinoma).

Symptoms[edit | edit source]

The bladder tamponade is for patient very painful, overfull bladder is palpable above the pubic spine. Patient is not able to urinate despite strong urgency. Hematuria may precede. The most dangerous complication is hemorrhagic shock based on the lost of blood.

Diagnostic[edit | edit source]

Diagnose is based on patient's symptoms and on endoscopic examination – cystoscopy. We have to check patients blood pressure, respiratory and heart rate because of possible hemorrhagic shock. Other necessary procedure is laboratory examination of blood (blood elements, coagulation parameters, biochemistry).

Foley's catheter inserted in urinary bladder.

Therapy[edit | edit source]

  • peripheral venous catheter
  • volume replacement therapy
  • drainage and lavage of urinary bladder: three-way Foley's catheter insertion, lavage by saline solution (blood clot formations are too big, they must be dissolved).

The final treatment is cystoscopy with electrocoagulation of bleeding areas in bladder. Future detail examination of the patient must follow! The most often cause is bladder cancer.

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