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In cases of extraperitoneal bladder rupture, the primary treatment typically involves urinary catheterization. This approach allows for the bladder to decompress and facilitates the healing of the injury by diverting urine away from the affected area. The extraperitoneal space, being the area outside the peritoneal cavity, is often not associated with the same level of risk for infection and complications as intraperitoneal ruptures.

Catheterization is effective because it helps manage the bladder's contents, reducing the pressure and allowing any tears or lesions to heal without direct urine exposure. Patients are often monitored closely during this process, and while some may require additional interventions depending on the severity of the injury, initial management with catheterization is a widely accepted practice.

Other options like immediate surgical repair or interventional radiology are more appropriate for intraperitoneal injuries or cases where there is significant displacement or ongoing haemorrhage. Observation and bed rest might sometimes be suitable for very minor cases, but they generally lack the proactive management of urinary diversion, making catheterization the most effective initial treatment strategy in this scenario.