Quick summary
Bladder rupture classification, CT cystography, and urethral injury grading — with structured reporting checklists.
Bladder Rupture
| Type |
Location |
Key Feature |
| Intraperitoneal |
Dome (weakest point) |
Contrast tracks along bowel loops, paracolic gutters — surgical repair |
| Extraperitoneal |
Anterolateral wall |
Contrast in perivesical space (flame-shaped); usually associated with pelvic fracture — catheter drainage often sufficient |
| Combined |
Both |
Surgical repair |
Bladder Reporting Checklist
- Type: extraperitoneal (EPR) / intraperitoneal (IPR) / combined — per CT cystography
- Defect location: anterior wall / posterior wall / dome / bladder neck
- Extent of extravasation: EPR (flame-shaped perivesical) / IPR (contrast outlining bowel loops)
- Pelvic hematoma: size and location (perivesical / pre-sacral)
- Associated pelvic ring fracture: present / absent
- Urethral injury signs: urethral disruption / Foley catheter malposition
- Foley catheter position: within bladder / malpositioned / not present
Urethral Injuries
| Type |
Description |
| Type I |
Stretch / elongation, no extravasation |
| Type II |
Partial disruption above urogenital diaphragm (UGD) |
| Type III |
Complete disruption above UGD (most common posterior injury) |
| Type IV |
Bladder neck injury |
| Type V |
Partial / complete anterior urethral injury |
Retrograde urethrogram is required to evaluate for urethral injury before catheter placement in pelvic fracture with blood at urethral meatus, perineal bruising, or inability to void.
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