Bladder injuries can be caused by blunt, penetrating, or iatrogenic trauma. If the perforation is above the peritoneal reflection and on the dome of the bladder, the extravasation is intraperitoneal. If the injury is below the peritoneal reflection but not on the dome of the bladder, the extravasation is extraperitoneal. Most extraperitoneal bladder leaks are effectively managed by maximal bladder drainage per urethral or suprapubic catheter. Almost every intraperitoneal bladder rupture requires surgical intervention.