How JustAnswer Works:

  • Ask an Expert
    Experts are full of valuable knowledge and are ready to help with any question. Credentials confirmed by a Fortune 500 verification firm.
  • Get a Professional Answer
    Via email, text message, or notification as you wait on our site.
    Ask follow up questions if you need to.
  • 100% Satisfaction Guarantee
    Rate the answer you receive.

Ask Dr. Y. Your Own Question

Dr. Y.
Dr. Y., Urologist
Category: Urology
Satisfied Customers: 18812
Experience:  I am fellowship trained specializing in general urology and reconstructive urology.
32613003
Type Your Urology Question Here...
Dr. Y. is online now
A new question is answered every 9 seconds

Can a punctured bladder be fixed If so, how

Resolved Question:

Can a punctured bladder be fixed? If so, how?

Wife thinks non-elastic outside layer of the 2006 radiation-damaged bladder cracked due to incredible pressure of 500cc urine. Did an internal healthy layer of bladder take the path of least resistance and possibly got nicked (punctured) as it expanded through the outside "crust"? The thrombosis may be sealing the hole on inside of the bladder and/or the piece of "crust" is still stuck in the retracted bladder. Docs nixed dissolving clot with enzymes or suctioning it out. (Speaks to the puncture theory.) Where to look for 5 units of blood? Certainly did not all come down the catheter.    
Submitted: 4 years ago.
Category: Urology
Expert:  Dr. Y. replied 4 years ago.
Hi there,

Thanks for your question. Please be patient for a response as I may be in the OR or driving, but will get back to you ASAP.

If the bladder look normal when the cystoscope was placed into the bladder, then he does not have a bladder rupture or a puncture in the bladder. People who have a bladder rupture become extremely ill with extreme abdominal pain. It is not like the outer side of the bladder develops a hole without a hole on the inside. The enlarged capacity was from urinary retention from the clots in the bladder. He certainly can lose five units of blood just through the catheter alone . If he continues to bleed, he will have to have medication such as formalin placed into the bladder to stop the bleeding. Hope this helps him please let me know if you have any other questions I can answer.
Customer: replied 4 years ago.

A time line for you. Radiation performed 2006. Cystoscopy & volume study done in 2007 with theory of radiation-damage-to-only-outside-of-bladder propounded for frequent urination, not responding to usual meds. Now- Sept.2010 - patient sent from a hospital to a rehab (PT), then to another hospital for emergency breathing issue. At 2nd hospital, urinary tract started producing blood/clots. The ultrasound was done with results as specified. After 45 days in ICU, patient was sent to a ventilator weaning hospital/rehab still with his unresolved urinary tract problem. Two weeks later and another round of IV antibiotics - cefepime & vancomycin - urinary tract still produces blood & clots. Would a thorough look at bladder (cystoscopy & exterior via laproscopy) be next? Or the formalin?

Also, would you please address just the original question in case a puncture did occur? How would you fix it?. Thank you very much.

 

Expert:  Dr. Y. replied 4 years ago.
A trip to the OR with cystoscopy is the next course of action to get the clots out and stop the bleeding with cautery. There is no role for laparoscopy in this situation. If there is no hole on the inside of the bladder, there is not going to be a hole on the outside. Even if the outside of the bladder was damaged from radiation, this would not have any effect on the bleeding as the bleeding comes from the mucosa on the inside. If a puncture occurred, it only needs to be fixed with an open exploration if the hole enters the abdominal cavity. If it does not enter the abdominal cavity, then the treatment is to leave a catheter in the bladder for 2 weeks and the hole will heal up on its own.
Dr. Y., Urologist
Category: Urology
Satisfied Customers: 18812
Experience: I am fellowship trained specializing in general urology and reconstructive urology.
Dr. Y. and other Urology Specialists are ready to help you

JustAnswer in the News:

 
 
 
Ask-a-doc Web sites: If you've got a quick question, you can try to get an answer from sites that say they have various specialists on hand to give quick answers... Justanswer.com.
JustAnswer.com...has seen a spike since October in legal questions from readers about layoffs, unemployment and severance.
Web sites like justanswer.com/legal
...leave nothing to chance.
Traffic on JustAnswer rose 14 percent...and had nearly 400,000 page views in 30 days...inquiries related to stress, high blood pressure, drinking and heart pain jumped 33 percent.
Tory Johnson, GMA Workplace Contributor, discusses work-from-home jobs, such as JustAnswer in which verified Experts answer people’s questions.
I will tell you that...the things you have to go through to be an Expert are quite rigorous.
 
 
 

What Customers are Saying:

 
 
 
  • I feel so much better today, and upon further investigation believe that there is a chance that the responses I got saved me from a serious, even life threatening situation. I am very grateful to the experts who answered me. Susan O. USA
< Last | Next >
  • I feel so much better today, and upon further investigation believe that there is a chance that the responses I got saved me from a serious, even life threatening situation. I am very grateful to the experts who answered me. Susan O. USA
  • I can go as far as to say it could have resulted in saving my sons life and our entire family now knows what bipolar is and how to assist and understand my most wonderful son, brother and friend to all who loves him dearly. Thank you very much Corrie Moll Pretoria, South Africa
  • I thank-you so much! It really helped to have this information and confirmation. We will watch her carefully and get her in for the examination and US right away if things do not improve. God bless you as well! Claudia Albuquerque, NM
  • Outstanding response time less than 6 minutes. Answered the question professionally and with a great deal of compassion. Kevin Beaverton, OR
  • Suggested diagnosis was what I hoped and will take this info to my doctor's appointment next week.
    I feel better already! Thank you.
    Elanor Tracy, CA
  • Thank you to the Physician who answered my question today. The answer was far more informative than what I got from the Physicians I saw in person for my problem. Julie Lockesburg, AR
  • You have been more help than you know. I seriously don't know what my sisters situation would be today if you had not gone above and beyond just answering my questions. John and Stefanie Tucson, AZ
 
 
 

Meet The Experts:

 
 
 
  • Dr. Y.

    Urologist

    Satisfied Customers:

    17592
    Specializing in general urology and reconstructive urology.
< Last | Next >
  • http://ww2.justanswer.com/uploads/lyeung1/2010-07-25_032152_tn_IMG_0241.JPG Dr. Y.'s Avatar

    Dr. Y.

    Urologist

    Satisfied Customers:

    17592
    Specializing in general urology and reconstructive urology.
  • http://ww2.justanswer.com/uploads/TH/tharun/2012-4-16_192945_passportyellow.64x64.jpg Dr. Tharun's Avatar

    Dr. Tharun

    Urology Resident

    Satisfied Customers:

    1177
    MBBS, DNB surgery and presently working as Urology resident towards the degree of Urologist.
  • /img/opt/shirt.png Dr. B's Avatar

    Dr. B

    Urologist

    Satisfied Customers:

    62
    Trained in Adult and Pediatric Urology, Fellowship trained in Urologic Oncology.
  • http://ww2.justanswer.com/uploads/DR/DrThomasMd/2012-7-25_134438_Imagess1.64x64.jpg Dr. Thomas, MD's Avatar

    Dr. Thomas, MD

    Board Certified Physician

    Satisfied Customers:

    44473
    Internal Medicine--practice all of internal medicine, all ages, family, also Integrative, CAM, etc
  • http://ww2.justanswer.com/uploads/MY/mysticdoc/2012-6-8_15615_mysticdoc3.64x64.jpg Dr. D.J.'s Avatar

    Dr. D.J.

    Board Certified Physician

    Satisfied Customers:

    13579
    MD
  • http://ww2.justanswer.com/uploads/agketch/2008-7-14_184046_drketchresized.jpg Dr. Ketch's Avatar

    Dr. Ketch

    Board Certified Physician

    Satisfied Customers:

    76
    Medical Degree, Former Assistant Professor at School of Medicine at Yale University
 
 
 

Related Urology Questions

Chat Now With An Urologist
Dr. Y.
Dr. Y.
Urologist
18812 Satisfied Customers
I am fellowship trained specializing in general urology and reconstructive urology.