Urinary bladder tamponade-an urological emergency

• Published in: Urologie (Heidelberg, Germany) Vol. 63; no. 6; p. 578
• Main Authors: Steffens, Felix, Grüne, Britta, Rassweiler-Seyfried, Marie-Claire
• Format: Journal Article
• Language: German
• Published: Germany 01.06.2024
• Subjects: Aged, 80 and over; Emergencies; Hematuria - diagnosis; Hematuria - etiology; Hematuria - therapy; Humans; Male; Urinary Bladder Diseases - diagnosis; Urinary Bladder Diseases - therapy; Urinary Catheterization - methods; Bladder; Bladder tamponade; Catheterization; Hematuria; Ultrasound imaging
• ISSN: 2731-7072; 2731-7072
• DOI: 10.1007/s00120-024-02340-4

Urinary bladder tamponade is a urological emergency that is part of the clinical routine of every urologist and requires immediate and adequate diagnosis and therapy. Presentation of the clinical picture of urinary bladder tamponade including etiology, diagnostics, and therapy as well as formulation of recommendations for action for clinical routine. Structured presentation of the diagnosis and therapy of urinary bladder tamponade with practical recommendations for action based on a current literature search and a clinical case study. Urinary bladder tamponade is a usually painful filling of the urinary bladder with blood clots as part of gross hematuria. The central pillars of diagnostics are anamnesis, targeted physical examination, and sonography. Therapy involves the rapid insertion of a flushing catheter with manual evacuation of the tamponade. A flushing catheter with at least 20 French should be used here. Timely diagnosis and prompt treatment are crucial. This usually includes transurethral catheter insertion with manual evacuation. If the tamponade is unsuccessfully removed, further measures such as endoscopic evacuation or, as a last resort, sectio alta or radical cystectomy are available.