Bladder rupture used to affect only men who consumed alcohol in excess. However, cases of binge-drinking women whose bladders have ruptured are starting to emerge, according to an article in the British Medical Journal (BMJ), this week’s issue.

The authors report that recently three women who attended hospital with lower abdominal pain had bladder rupture – a rare condition. The authors add that binge drinking in the UK continues to grow apace. In fact, alcohol abuse is estimated to cost the National Health Service (NHS) approximately £3 billion annually, involving in excess of 28,000 hospital admissions caused by either alcohol dependence or alcohol poisoning. It is estimated that 22,000 people die early in the UK annually as a result of alcohol related problems.

In the UK the gap between male and female alcohol consumption has closed completely. Concerns that used to involve mainly men, now include women as well, and probably in equal numbers, the researchers explain.

Dr Mohantha Dooldeniya and team describe three women who went to Pindefields Hospital, Wakefield, West Yorkshire, England, complaining of lower abdominal pain. All three of them had consumed excessive amounts of alcohol not long before their hospital visits.

Two of the patients had symptoms of sepsis (urinary infection) and were treated with antibiotics to start with – they were also rehydrated. The third patient was initially thought to have come in with appendicitis as her symptoms coincided (with those of appendicitis).

However, following further investigation it was confirmed that all three women’s bladders had ruptured. They all underwent surgery to repair their bladders. In all three cases, doctors believe the cause was diureses (increased discharge of urine) and the dulling effect of alcohol, without the relief of bladder voiding, caused the ruptures – in other words, their levels of alcohol were such that they did not empty their bladders as their sensations were numbed (put more bluntly – when you’re drunk, you may wait too long before you realize you have to to pee).

The more alcohol you consume in one session the higher the volume of liquid your bladder holds, explain the researchers. As alcohol dulls the senses, the urge to empty one’s bladder is not there, even though it may be completely full. If you suffer some minor trauma during that time, such as a fall, the risk of bladder rupture is serious. It is a vicious circle, because a person who has drunk too much alcohol is also more likely to experience a minor fall, compared to somebody who has consumed no alcohol at all.

The authors conclude that as women are consuming much more alcohol today, complications previously seen just in men should be considered for both sexes.

“Lower abdominal pain in women after binge drinking”
BMJ 2007;335:992-993 (10 November), doi:10.1136/bmj.39247.454005.BE
M D Dooldeniya, R Khafagy, H Mashaly, A J Browning, S K Sundaram, C S Biyani
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Written by – Christian Nordqvist