Bladder Injury Algorithm

Based on Woodle et al., Genitourinary Trauma: What You Need to Know (J Trauma Acute Care Surg, 2026)

1 step

A: Suspected Bladder Injury

Start

Bladder injuries occur most often with blunt trauma and pelvic fractures. The hallmark is gross hematuria; also consider injury with suprapubic pain, inability to void, or blood at the urethral meatus.

Clinical Note

Gross hematuria in the setting of a pelvic fracture mandates bladder imaging. Microscopic hematuria alone rarely indicates bladder rupture.