Albaddai Nasser, Alkohlany Khaled, Shamsan Aziz, Alsaqaf Wael, Al-Sakkaf Abdullah, Farei Ahmed, Al-Baidai Abdaljaleel
Urology Specialist, Arab Board of Urology - Urology Department, General Military Hospital (GMH), Amman , Jordan.
Assoc. Prof. of Urology - Sana'a University, Sanaa, Yemen, Department of Urology, General Coordinator of Arab Board of Urology in Yemen, Supervisor of Arab Board Program of Urology in GMH - Head of Urology Department, Amman, Jordan.
BMC Urol. 2025 Jul 21;25(1):178. doi: 10.1186/s12894-025-01863-y.
Urinary bladder (UB) injuries pose significant challenges in conflict zones, yet evidence on optimal management in resource-limited settings remains scarce. This study evaluates outcomes of conservative and surgical approaches for UB injuries in war-torn Yemen.
This prospective observational study was conducted at a tertiary military hospital in Sana'a, Yemen, from February 2021 to January 2023. Forty-four patients with traumatic UB injuries were enrolled. Injuries were classified by mechanism, AAST grade, and anatomical location. Conservative management included catheterization and antibiotics, while surgical intervention was guided by injury severity and associated trauma. Outcomes included healing confirmed by cystography, complication rates (Clavien-Dindo classification), and length of hospital stay.
Of 44 patients (95.5% male; mean age 26.8 ± 8.6 years), 77.3% underwent surgical repair, primarily for penetrating injuries and high-grade bladder trauma. Conservative management was applied in 22.7% of low-grade extraperitoneal cases. Surgical success rate was 97.1%, while conservative success reached 80%. Most patients (82.4%) had extraperitoneal injuries; associated trauma was common, including pelvic/femur fractures (68.2%) and abdominal/pelvic organ injuries (36.4%). Complications occurred in 36.4% of patients, with 13.6% being moderate to severe (Grade III-IV). No bladder injury-related mortalities occurred. Pelvic fractures significantly increased the odds of surgical repair (OR 4.2, p = 0.001) and late sepsis (OR 5.6, p = 0.02).
In conflict settings, surgical repair remains critical for high-grade UB injuries, while conservative management is viable for select low-grade cases. Prolonged hospitalization reflects polytrauma burden rather than surgical intervention itself.
膀胱损伤在冲突地区带来了重大挑战，但在资源有限的环境中关于最佳管理的证据仍然稀缺。本研究评估了在饱受战争蹂躏的也门，膀胱损伤的保守和手术治疗方法的结果。
这项前瞻性观察性研究于2021年2月至2023年1月在也门萨那的一家三级军事医院进行。纳入了44例创伤性膀胱损伤患者。损伤根据机制、美国创伤外科学会（AAST）分级和解剖位置进行分类。保守治疗包括导尿和使用抗生素，而手术干预则根据损伤严重程度和相关创伤情况进行。结果包括通过膀胱造影确认的愈合情况、并发症发生率（Clavien-Dindo分类）和住院时间。
44例患者（95.5%为男性；平均年龄26.
