Urology: bladder injury: practice question

A General Surgery question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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General Surgery · Urology: bladder injury

Sample item

A 30-year-old man with a pelvic fracture after a road accident has lower abdominal pain, cannot void, and has gross haematuria. A retrograde cystogram shows contrast outlining loops of bowel and filling the paracolic gutters. What is the correct management?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

A. Laparotomy with surgical repair of the bladder and catheter drainage

Intraperitoneal bladder rupture occurs when a full bladder bursts at the dome and urine leaks into the peritoneal cavity. It does not heal with catheter drainage and requires surgical repair in layers, followed by catheter drainage. Uncomplicated extraperitoneal ruptures, with a flame-shaped extravasation in the pelvis, are usually treated with catheter drainage alone.

Option by option

  • A. Laparotomy with surgical repair of the bladder and catheter drainage (correct)

    Contrast around bowel indicates intraperitoneal rupture, which needs operative repair.

  • B. Observation with intravenous fluids

    Observation risks urinary ascites, peritonitis and sepsis.

  • C. Urethral catheter drainage alone for 10 to 14 days

    Catheter drainage alone is adequate for most extraperitoneal ruptures only.

  • D. Bilateral percutaneous nephrostomies

    Nephrostomies would not divert urine leaking from a bladder tear.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

More General Surgery questions

Questions about this General Surgery question

What is the answer to this General Surgery question?

The best answer is A, Laparotomy with surgical repair of the bladder and catheter drainage. Intraperitoneal bladder rupture occurs when a full bladder bursts at the dome and urine leaks into the peritoneal cavity.

Why is "Observation with intravenous fluids" not the answer?

Observation risks urinary ascites, peritonitis and sepsis.

Why is "Urethral catheter drainage alone for 10 to 14 days" not the answer?

Catheter drainage alone is adequate for most extraperitoneal ruptures only.

Why is "Bilateral percutaneous nephrostomies" not the answer?

Nephrostomies would not divert urine leaking from a bladder tear.

What concept does this question test?

It tests Urology: bladder injury in General Surgery. It does not heal with catheter drainage and requires surgical repair in layers, followed by catheter drainage. Uncomplicated extraperitoneal ruptures, with a flame-shaped extravasation in the pelvis, are usually treated with catheter drainage alone.

How hard is this question?

We tag it as a multi-step question: it asks you to combine more than one idea. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Urology: bladder injury?

Learn classic signs and eponyms alongside what they diagnose. Then use the flashcards and the other General Surgery questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.