Bladder

Bladder Rupture

  • Comes in two flavors - intra-peritoneal & extra-peritoneal

  • Extra-peritoneal bladder rupture

    • Much more common, ~ 90% of cases

    • Result of trauma (pelvic fractures), sometimes after instrumentation/procedures

    • Look for contrast pretty much anywhere other than between bowel loops

    • Treatment = foley catheter

  • Intra-peritoneal bladder rupture

    • Less common, ~10% of cases

    • Result of direct blow to a distended bladder

    • Rupture typically at dome of bladder

    • Look for contrast in between bowel loops or at paracolic gutters

    • Treatment = surgery

Bladder Cancer

Urothelial (Transitional) Cell Carcinoma

  • 95% of bladder cancers

Squamous cell carcinoma

  • Associated with paraplegic patients

  • Seen with chronic bladder irritation

    • Chronic indwelling catheters

    • Bladder stones

    • Cyclophosphamide use

Cystitis Cystica

  • Chronic irritation of bladder lining causing multiple peripheral cystic lesions

  • Can be irritation from stones, infection, etc

  • Chance of malignant transformation to adenocarcinoma

Adenocarcinoma

  • Associated with urachal remnants

Urethral Diverticulum

  • Cystic fluid collection surrounding the urethra

  • Presents as triad of 3Ds

    • Dysuria

    • Dyspareunia

    • Postvoid Dribbling

  • Complications

    • Infection

    • Stone formation

    • Malignancy

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