Impalement with associated bladder injuries was observed in 4 patients. The treatment should be individualised but careful debridement of all necrotic tissue, urinary and fecal diversion, separation of the injured sites with wall-vascularised tissue such as peritoneum or omentum should reduce the high incidence of fistulae or bladder stones. Endoscopic or surgical exploration of the bladder is mandatory because foreign bodies risk creating calculi, like in our 2 cases.
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