Initial management of uroabdomen includes which of the following?

• A. Drain peritoneal fluid slowly
• B. Place urinary catheter
• C. Provide IV fluids and diuresis
• D. All of the above

Answer: (D)

Uroabdomen creates a life-threatening mix of hypovolemia and electrolyte/azotemia because urine in the peritoneal cavity is lost from the vasculature and its components are reabsorbed across the peritoneum. The initial approach is to stabilize the patient while minimizing further urine leakage and contamination.

Giving IV fluids immediately helps restore intravascular volume, improves blood pressure, and supports kidney perfusion, which is crucial as the kidneys try to handle the waste products that are reabsorbed from the abdominal fluid. At the same time, placing a urinary catheter diverts urine away from the peritoneal cavity, reduces ongoing leakage, and lets you monitor urine output to gauge stabilization.

If there is a significant amount of intraperitoneal urine, draining the peritoneal fluid gradually can relieve abdominal distension and decrease toxin load from absorption, but this is done slowly to avoid rapid shifts in electrolytes and acid–base balance.

Once stabilization is underway, promoting adequate urine production (diuresis) aids in flushing waste products and supporting renal recovery, though it must be done with careful monitoring of fluid and electrolyte status. Ultimately, definitive treatment requires surgical repair of the bladder rupture to stop the source of leakage.