As levels of binge drinking in the UK rise, doctors in this week’s BMJ report three cases of bladder rupture in women who attended hospital with lower abdominal pain.
Although rare, this condition has previously only been seen in men after excessive alcohol intake.
Alcohol misuse is costing the NHS up to £3bn a year, with over 28,000 hospital admissions cause by alcohol dependence or poisoning and 22,000 premature deaths each year caused by problems related to alcohol.
Women have now caught up with men in their alcohol consumption, and health concerns that were initially raised about drinking habits in men now seem to affect women as well.
Dr Mohantha Dooldeniya and colleagues describe three women who presented to Pinderfields Hospital with lower abdominal pain after excessive alcohol consumption.
The first two patients presented with symptoms consistent with urinary infection (sepsis) and were initially treated with antibiotics and rehydration. In the third woman, doctors initially suspected appendicitis because of the localisation of the pain.
After further investigation, bladder rupture was confirmed and all women underwent surgery to repair the bladder.
In all these cases, diuresis (increased discharge of urine) and the dulling effect of alcohol, without the relief of bladder voiding, was thought to be the cause.
Alcohol consumption increases the volume of urine held within the bladder and dulls the senses such that the patient has a reduced urge to void despite the increased bladder volume, say the authors. Minor trauma, such as from a fall, will further increase the pressure and can cause rupture.
They suggest that with the increase in alcohol consumption in women today, the complications previously seen only in men should now also be considered.