the patient has not been able to pass urine for 2 days, almo | Figure 1

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Emergency Medicine

The patient has not been able to pass urine for 2 days, almost 500ml urine in the bladder, reports being constipated, no significant hx, what's lying on the bladder floor?

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Similar cases

Sagittal CT cystogram shows an extraperitoneal bladder rupture (arrow). Contrast/urine also extends through a defect (dashed arrow) in the anterior abdominal wall. Extraperitoneal rupture is the most common type of bladder rupture and is usually associated with pelvic fractures or penetrating trauma. Intraperitoneal bladder rupture is usually caused by direct blunt trauma to a full bladder.

Postoperative interventions for preventing bladder dysfunction after radical hysterectomy in women with early-stage cervical cancer:
The issue:
Radical hysterectomy with pelvic lymphadenectomy is the treatment for early-stage cervical cancer. Bladder dysfunction is a common problem following radical hysterectomy.
The aim of the review:
To assess the usefulness and safety of treatment to prevent bladder dysfunction following radical hysterectomy.
Main findings:
We found four studies that met the inclusion criteria.
Bethanechol versus placebo: Bethanecol may reduce the chance of bladder dysfunction by lowering the volume of post-void residual urine. However, the certainty of this evidence is very low.
Suprapubic catheterisation versus intermittent self-catheterisation: There was insufficient evidence to indicate the effectiveness of either treatment.
Conclusions: None of the included studies reported important outcomes for assessing postoperative bladder dysfunction, and the effectiveness of different types of postoperative urinary catheterisation remains unproven.