Genitourinary trauma

Upper Tract Injuries (kidney + ureter)

• Majority of blunt trauma injuries present w/ hematuria
• Renal pedicle injuries and penetrating injuries to ureter may not cause hematuria
• Renal injuries are a/w flank hematoma, lower rib fx, penetrating wounds to flanks

Diagnosis

• Who to image?
  • Penetrating Trauma
    • Any degree of hematuria
  • Blunt Trauma
    • Gross hematuria
    • Hypotension and any degree of hematuria
    • Child with >50rbc/HPF
    • High index of suspicion for renal trauma
      • Deceleration injuries even with no hematuria
      • Multiple trauma pt

DDX

• Renal Injuries
• Ureter Injuries

Lower Tract Injuries (bladder + urethra + genitalia)

• Often accompany pelvic fracture

Genitourinary Trauma

• Urinary system
  • Renal trauma
  • Ureter trauma
  • Bladder trauma
  • Urethral trauma
    • Traumatic foley catheter removal
• Genital
  • Penile trauma
    • Traumatic foley catheter removal
  • Testicular trauma
  • Vaginal trauma
• Other
  • Child abuse
  • Pelvic fracture (often accompanies)
  • Sexual assault

See Also

• Traumatic Foley Catheter Removal
• Abdominal trauma

Source

Tintinalli