Urological Trauma in the Pacific Northwest: Etiology, Distribution, Management and Outcome

Abstract

A computer-assisted review identified 184 patients with genitourinary tract injuries among 5400 hospitalized for trauma. Particular attention was directed to the controversial groups of patients with blunt renal and posterior urethral injuries. Management of renal injuries was based on clinical criteria. Subsequent renal exploration was necessary in only 1 of 115 patients with renal contrusions, or simple or deep lacerations who underwent initial expectant management. Followup was available in all patients with severe renal injuries and in 53% with renal contusions or simple suffered hypertension, hydronephrosis or other sequelae. A staged approach was preferable to immediate repair of posterior urethral injuries. Seven patients managed by initial cystostomy drainage followed by secondary urethral repairs did well. Primary realignment was complicated by stricture, incontinence or impotence in 3 of 6 patients.