Urologic trauma

Abstract

The genitourinary trauma represents 10% of all traumas in our Emergency Service (HC-FMUSP). The kidney is the organ most frequently affected. The ureteral and bladder traumas are rarer and are associated with traumas of high energy and with other severe injuries. The ureteral injuries are, mostly, caused by penetrating traumas or by surgical and iatrogenic injuries. The urethral injuries, otherwise, are associated with pelvis fracture in almost all cases and withbladder injury in 10 to 17% of the cases. An essential principle to be applied on diagnosis of urologic injuries is the evaluation of the mechanisms and the energy involved in the trauma, especially in victims of blunt injuries. Knowing the etiology, physiopathology, diagnosis and treatment of the genitourinary trauma is essential for the correct approach of the polytraumatized patient at the Emergency Service. The interaction between the Urologist and the Trauma Surgeon since the earlier moments at the emergency room can help to guide the therapeutic decisions on an integrated and congruent way. In this article we will discuss the main aspects of diagnosis and treatment of genitourinary tract trauma.