Clinical Presentation & Protocol
Patient Usually Complains Of
Patient presents with history of blunt pelvic trauma. Reports suprapubic pain, gross hematuria, and inability to void. No signs of peritonitis. History of pelvic fracture confirmed on imaging.
Clinical Examination Findings
Abdominal exam: Suprapubic tenderness, no rebound tenderness or guarding. Genitourinary: Blood at the urethral meatus (rule out urethral injury), stable pelvic ring (if fixed), or evidence of pelvic fracture. Rectal exam: Prostate position normal, no high-riding prostate.
Treatment Protocol
Conservative management indicated for uncomplicated extraperitoneal rupture. Placement of large-bore Foley catheter for continuous bladder drainage (typically 10-14 days). Serial monitoring of hematuria and repeat cystogram prior to catheter removal. Prophylactic antibiotics as indicated.