The Bladder is an Important Organ

[William Bromberg]

My indications

I will perform a handheld RUG for 1. blood at the meatus. 2. high riding prostate 3. Findings on plain film that make me worry that fractures could have gone near the urethra (vague, yes, sorry)

I will perform a cystogram (plain film full and empty) for 1.  gross hematuria or 2. no urine obtained on foley placement in patient with pelvic fractures 

These patients usually go to CT scan afterwards (if stable and no obvious intraperitoneal bladder rupture on cysto). Sometimes CT will pick up small EP leaks that don't get seen on plain film.

Bill Bromberg

>>> "caesar ursic" <cmursic at gmail.com> 2/1/2008 2:01 PM >>>
(FYI:  January is Bladder Health and Injury Prevention Month.)

Two question for the group:

1. When do you specifically screen for bladder injuries in your
polytraumatized (blunt) patients?


2. How do you do it?
A. CT scan.  Do you clamp the urinary catheter first?  Do you instill
contrast into the bladder prior to scanning?
B. Retrograde cystogram (i.e. instilling contrast via the bladder catheter
and shooting plain films)?
C. Other?

Many Thanks, etc.

C Ursic, MD
Santa Fe, USA
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