Urinary tract injuries in patients with multiple trauma

Abstract

This article mainly reviews urinary tract injuries in patients with multiple trauma. Approximately 10% of all traumatic injuries resulting from an external force will involve the genitourinary system. The article discusses mechanisms of injury, diagnosis, and therapeutical approaches for renal, ureteral, bladder, and urethral trauma. Due to the complexity of such injuries--despite several attempts to provide a standard strategy in trauma patients with urinary tract involvement--an individual and patient-specific-therapeutic approach is mandatory in most cases. However, the availability of classified guidelines may help the surgeon to reach the most accurate decision. Because of the similarity of American and European guidelines on urological trauma, this article adapts injury severity scales and classification from the American Association for the Surgery of Trauma.

Evaluation of urogenital injuries in patients with trauma at the emergency department

“…Fakat hasar şiddeti ile hematüri varlı-ğı, yokluğu veya seviyesi ile böbrek hasarı şiddeti arasında ilişkinin olmadığı daha önce başka çalışmalar-da gösterilmiştir. [7,20,21] Bizim çalışmamızda ürogenital bölgeye olan travmalarda ürogenital organ yaralanması olan ve olmayan hasta grupları hematüri yönünden karşılaştırıldığında anlamlı bir fark saptanmadı. Genel bir kabul olarak ürogenital bölge travmalarında hematüri sıklığının yüksek olması nedeniyle organ yaralanması olup olmadığını öngörmede idrar incelemesinin çok anlamlı olmadığı düşünüldü.…”

Complexity of non-iatrogenic ureteral injuries in children: single-center experience

“…Management strategies for non-iatrogenic ureteral injuries in adult have been widely overviewed and discussed very well in many occasions [2][3][4][5]. On the other hand, pediatric trauma has scarce literature contribution.…”

“…Most published series involve adult age groups above 16 years of age, while injuries to children were mostly case reports [2,3]. This implies the rarity of kind injury in pediatric age group.…”

Trauma of the Kidney, Ureter, and Bladder

“…In blunt trauma, 43 % of GU injuries are to the kidney, 9 % to the bladder, and 47 % to the external genitalia. Ureteral injuries are relatively rare in blunt trauma [ 2 ] and account for less than 1 % of all urologic trauma [ 5 ].…”

“…Although not often the cause of significant shock, GU trauma frequently occurs in the setting of multi-trauma and may be overlooked, causing significant morbidity [ 5 ]. Blunt trauma accounts for 80-90 % of GU injuries [ 6 , 7 ]; however, in an urban setting, penetrating trauma may cause up to 20 % of GU trauma [ 8 ].…”