A Prospective Study on the Management of Urinary Bladder Injuries in a Military Hospital in Yemen

Background and OBJECTIVE : Urinary Bladder (UB) injuries are a significant concern in conflict zones, leading to morbidity and mortality. This study aimed to evaluate the effectiveness of conservative and surgical management of UB injuries at a single center in Yemen. Methods: A prospective observational study was conducted in single center in Yemen, between February 2021 and January 2023. Forty-four patients (42 males, 2 females) with isolated or associated UB injuries were included, with a mean age of 26.8 years. Data collected included demographic information, clinical data, imaging studies, operative reports, and follow-up data. Results: Penetrating trauma of UB was the most common cause of injury (72.7%), often associated with pelvic and femur fractures (68.2%). Conservative management was applied in 22.7% of cases, while 77.3% underwent surgical repair. Postoperative cystography revealed successful healing in over 90% of patients, with a mean hospital stay of 24.5 days. Early complications (50% in surgical vs. 20% in conservative groups) included continuous leakage (50%), urinary tract infection (31.8%), and clot formation (4.5%). Late complications in patients with prolonged catheterization included recurrent UTI (18.2%), vesicocutaneous fistula (9.1%), and sepsis (4.5%). The surgical group had a higher success rate (97.1%) compared to the conservative group (80%). The surgical group also had a statistically significant longer length of hospital stay (mean 28.7 days) compared to the conservative group (mean 18.5 days) (p-value = 0.02). Conclusion: This study provides valuable insights into the management of UB injuries in a war-torn setting. Both conservative and surgical management can be effective for penetrating UB injuries. The choice of treatment depends on the severity of the injury, patient characteristics, and available resources.