Trauma, Critical Care and Emergency Medicine

Urological Trauma

Urological Trauma is the most commonly injured organ in the genito-urinary system and renal trauma is seen in up to 5% of all trauma cases  and in 10% of all abdominal trauma cases . In MVAs, renal trauma is seen after direct impact into the seatbelt or steering wheel (frontal crashes) or from body panel intrusion in side impact crashes. Ureteral trauma is relatively rare but due mainly to iatrogenic injuries, and in penetrating gunshot wounds - both in military and civilian settings. Traumatic bladder injuries are usually due to blunt (MVA) causes and associated with pelvic fracture, although may also be a result of iatrogenic trauma. The anterior urethra is most commonly injured by blunt or “fall-astride” trauma, whereas the posterior urethra is usually injured in pelvic fracture cases - the majority of which are seen in MVAs. Genital trauma is much more common in males due to anatomical considerations and more frequent participation in physical sports, violence and war-fighting. Of all genitor-urinary injuries, 1/3-2/3rds involve the external genitalia.