A drunk swim didn’t end very well for one 24-year-old man, who ended up busting his bladder after diving into a lake. The Maine man arrived at the emergency room the day after the injury, complaining of severe pain in his abdomen. He told doctors the pain had begun immediately after he had jumped into the lake.

His abdomen was swollen when doctors examined him, and he couldn’t seem to make himself urinate. Doctors, who published a report on the incident, inserted a catheter only to reveal urine filled with blood. A computed tomography (CT) scan revealed the problem: there was a ragged rupture on the top of the bladder, which is normally smooth. The man underwent an operation, during which doctors stitched up his bladder.

The man’s activities had created a perfect storm for his injury, according to experts.

“When you drink alcohol, it causes the body to produce more urine than usual, so that can potentially contribute to the bladder being full,” said Dr. Bradley Gill, a resident in urology at the Cleveland Clinic, to Live Science.

Gill said that inebriated individuals don’t always notice when they have to urinate, and that the combination of unawareness and fullness could set them up for a bladder failure. Deciding to dive into the lake, apparently, was a terrible decision.

Gill called hitting the water with a bladder that full “the equivalent of throwing a water balloon on the sidewalk.”

Bladder Burst

A bladder is a muscular pouch capable of holding between 10 to 20 fluid ounces or urine. When full, the bladder is under pressure and vulnerable to outside forces that increase that pressure.

“If you imagine holding a water balloon between your two hands and squeezing it, the part that pushes out between your two hands is going to eventually bubble out and burst,” Gill said.

The doctors say in their report 35 to 40 percent of bladder ruptures are ‘intraperitoneal,” meaning they occur because of too much pressure on the bladder wall. Some common situations can cause the bladder to burst — Gill cites a child playing in an athletic event as an example. If a child resists leaving the game for a bathroom break, the bladder can get too full and burst if an errant ball happened to strike it.

If bladder rupture is the only injury, surgery is usually very successful, Gill said. Patients would have to use a catheter for a few weeks after surgery so the bladder can recover, but after that, things can return to normal.

Source: Leger J, Higgina G, Opacic, M. A Young Man with Abdominal Trauma and Inability to Void. The Journal of Emergency Medicine. 2015.