Genitourinary trauma

Upper Tract Injuries (kidney + ureter)

• Majority of blunt trauma injuries present with hematuria
• Renal pedicle injuries and penetrating injuries to ureter may not cause hematuria
• Renal injuries are associated with flank hematoma, lower rib fracture, penetrating wounds to flanks

Evaluation

• 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 patient

Types

• 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

Differential Diagnosis

Abdominal Trauma

• Abdominal compartment syndrome
• Diaphragmatic trauma
• Duodenal hematoma
• Genitourinary trauma
• Liver trauma
• Pelvic fractures
  • Acetabular pelvic fractures
  • Open book pelvic fracture
  • Straddle pelvic fracture
  • Pelvic avulsion fracture
• Retroperitoneal hemorrhage
• Renal trauma
• Splenic trauma
• Trauma in pregnancy
• Ureter trauma

See Also

• Traumatic Foley Catheter Removal
• Abdominal trauma
• Trauma (main)