Retrospective review of traumatic bladder injuries in a trauma unit in Johannesburg, South Africa

Background: Limited studies have focused on the outcomes of traumatic bladder injuries in low- and middle-income countries (LMICs), prompting this study to describe and evaluate the management and outcomes at a trauma unit. Methods: This retrospective study describes traumatic bladder injury management and outcomes (mortality) over a time duration of 5 years (2015–2019), addressing a gap in LMIC data. The study included adult trauma patients with confirmed traumatic bladder injuries, excluding iatrogenic cases and incomplete data. Data collected included demographics, injury mechanisms, injury types, diagnostic methods, management strategies, and associated injuries. Statistical analysis was conducted using STATA version 18. Results: Findings showed that 49 % of injuries were caused by blunt trauma, mainly motor vehicle accidents, while 51 % resulted from penetrating trauma, mostly gunshot wounds. Injuries were categorised as extraperitoneal (39 %) and intraperitoneal (38 %). Conservative treatment was often used for extraperitoneal traumatic bladder injuries. Penetrating injuries frequently needed surgical repair, mainly two-layer suturing with absorbable material. The mortality rate was low, with two deaths because of Adult Respiratory Distress Syndrome (ARDS) and pneumonia. Complications included fistula formation in 2.6 % of patients, managed conservatively and urinary tract infections in 3.9 %. Haematuria lasting more than five days was seen in four patients and cleared with catheterisation. One patient developed a pelvic abscess after preperitoneal pelvic packing. Conclusion: The low mortality rate and manageable complications like fistula and infections suggest outcomes can improve with proper management, even in resource-limited settings. Contribution: This study highlights patterns, management, and outcomes of traumatic bladder injuries in LMICs, emphasising the need for ongoing research and capacity-building to improve patient care.