DOI: 10.29188/2222-8543-2026-19-1-19-25
For citation:
Protoshchak V.V., Paronnikov M.V., Mitrofanov P.P., Karpushchenko E.G., Shpilenya E.S. Structure and characteristics of combat injuries to the bladder in modern armed conflict. Experimental and Clinical Urology 2026;19(1):19-25; https://doi.org/10.29188/2222-8543-2026-19-1-19-25
Protoshchak V.V., Paronnikov M.V., Mitrofanov P.P., Karpushchenko E.G., Shpilenya E.S.
Information about authors:
- Protoshchak V.V. – Dr. Sci., Professor, Head of the Department of Urology of the Federal State Budgetary Educational Institution of Higher Education «Military Medical Academy named after S.M. Kirov» of the Ministry of Defense of the Russian Federation, Saint-Petersburg, Russia; RSCI Author ID: 608157, https://orcid.org/0000-0002-4996-2927
- Paronnikov M.V. – Dr. Sci., Deputy Head of the Department of Urology «Military Medical Academy named after S.M. Kirov» of the Ministry of Defense of the Russian Federation, Saint-Petersburg, Russia; RSCI Author ID: 898084, https://orcid.org/0009-0005-1762-6100
- Mitrofanov P.P. – oncologist of the Oncology Department of Urology of the S.M. Kirov Military Medical Academy of the Ministry of Defense of the Russian Federation, Saint-Petersburg, Russia; RSCI Author ID: 1326541
- Karpushchenko E.G. – PhD, Senior Lecturer of the Department of Urology of the S.M. Kirov Military Medical Academy of the Ministry of Defense of the Russian Federation, Saint-Petersburg, Russia; RSCI Author ID: 774197, https://orcid.org/0000-0001-7464-5926
- Shpilenya E.S. – Dr. Sci., Professor, Professor of the Department of Urology of the I.I. Mechnikov Northwestern State Medical University of the Ministry of Health of the Russian Federation, Saint-Petersburg, Russia; RSCI Author ID: 907492, https://orcid.org/0000-0003-0479-6555
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Introduction. The use of new types of high-precision weapons and the widespread use of unmanned aerial vehicles have dramatically changed the structure and severity of combat injuries to the genitourinary system in general, and to bladder injuries in particular.
The purpose of the study. To analyze the frequency and structure of bladder injuries in modern armed conflicts.
Materials and methods. We analyzed the data from the primary medical files of wounded patients with bladder damage who were admitted to the S.M. Kirov Military Medical Academy. The data are presented in relative figures.
Results. Combat bladder trauma accounted for 11.5% of all injuries to the genitourinary system and was predominantly represented by gunshot wounds (94.5%). In 86.2% of cases, the trauma was combined, while isolated injuries accounted for 1.2%. Complete bladder wall rupture was diagnosed in 75.1% of cases, while incomplete rupture was observed in 9.7% of cases. Hematoma was detected in 6.9% of patients, and separation from the urethra was found in 8.3% of cases. In relation to abdominal cavity, extraperitoneal, intraperitoneal, and mixed in¬juries were found in 70.4; 19.4 and 10.2% of cases, respectively. According to the AAST (American Association for the Surgery of Trauma) classification, grade III, IV, and V injuries were found in 38.2; 35.4 and 9.9% of cases. Grade I and II injuries were diagnosed in 5.4 and 11.1% of cases, respectively. A complicated course of bladder injury was observed in 75% of the patients.
Conclusion. Bladder injuries in modern armed conflict are multiple, combined, and severe or extremely severe, requiring multiple staged operations. These findings highlight the urgent need for the development and implementation of modified pelvic protection devices.
