Bladder tamponade is a medical condition in which there is formation of numerous clots in the bladder resulting in potentially serious complications. In this article, we will discuss about the various causes, symptoms, and treatments for Bladder Tamponade.
How Is Bladder Tamponade Defined?
- The term Tamponade means blockage, especially to stop bleeding. Tamponade is an extremely useful way of stopping a hemorrhage.
- In Urology, Urinary Bladder Tamponade is a case of emergency in which the bladder is filled with formations of big blood clots.
- This clot formation is most usually caused by bladder carcinoma.
Causes Of Bladder Tamponade
- Bladder tamponade is caused by bladder cancer.1
- Bleeding cancer causes large amount of bleeding, which fills bladder space resulting in blockade (tamponed) of urinary flow.
- Bladder tamponed is also observed in pregnant patient suffering with placenta previa.2
Symptoms Of Bladder Tamponade
- Pain-
- Pain is severe and observed over pubic bone.
- Bladder Tamponade is extremely painful.
- Pain is spasmodic and intense.
- Soft To Firm Mass-
- The bladder can be palpated above the pubic spine.
- Consistency of bladder is soft to firm.
- Lack of Urine
- Unable to urinate for several hours
- Severe colic pain with intense desire to urinate
- Urine if discharged indicates red color because of blood in urine.
- Blood Loss
- Pale and anemic
- Tachycardia- Increased heat rate
- Hypotension- Low blood pressure
Diagnosis Of Bladder Tamponade
Clinical Examination-
- Lack of urine
- Hematuria- blood in urine
- Anemia
- Tachycardia
- Low Blood Pressure
- Supra-pubic (above pubic bone)- firm palpable mass
Lab Studies-
- Urine Examination
- Hematuria- Blood in urine
- Low urine volume
- Blood Examination
- Hemoglobin- low
- Red blood cell count- low
- Cystoscopy-
- Blood clots are seen in bladder
- Ultrasound study
- Blood clots are observed in bladder
- CT Scan
- Clots and blood observed in CT scan.
- Magnetic Resonance Study.
Treatment for Bladder Tamponade
Some of the Treatments Used For Bladder Tamponade are
- Intravenous fluid-
- Treat hypotension
- Tachycardia
- Blood Transfusion-
- Low hemoglobin
- Severe blood loss
- Cystoscopy-
- Evacuate blood clots
- Lavage or Irrigate urinary bladder with normal saline
- Stop bleeding by using laser or cautery.
- Suprapubic Endoscopy
- Cystoscopy is introduced through skin incision above pubic symphysis.3
- Blood clots are removed either by irrigation or using instruments.
- Bleeding is discontinued using cautery or laser.
References:
1. Leiomyoma of the urinary bladder causing tamponade.
Oh-Oka H1, Gotoh A, Hanioka K, Okada H.
Scand J Urol Nephrol. 1998 Dec;32(6):420-1.
2. Acute urinary bladder tamponade with hypovolemic shock due to placenta percreta with bladder invasion. Case report.
Aho AJ, Pulkkinen MO, Vähä-Eskeli K.
Scand J Urol Nephrol. 1985;19(2):157-9.
3. Percutaneous suprapubic endoscopy for treatment of bladder tamponade.
Golabek T, Powroźnik J, Szostek P1, Chłosta P, Borówka A Wideochir Inne Tech Malo Inwazyjne. 2013 Dec;8(4):364-5.
