Skip to main content
SpringerLink
Log in

Surgical Treatment of Kidney and Urinary Tract Trauma

  • Chapter
  • First Online:
Trauma Surgery

  • 2656 Accesses

Abstract

Trauma to the genitourinary (GU) tract can be challenging to manage. The kidney is the most common GU organ to be involved. Currently, most of renal trauma is managed medically. Identifying patients who require intervention is vital due to rates as high rates of nephrectomy when patients are surgically explored. The management of grade V trauma is the most critical, as decisions to proceed to the angiography suite versus the operating room will continue to be driven by trauma-centered protocols and concomitant injuries. Other areas of controversy exist in the timing of surgical management in urethral injuries as well as early repair of extraperitoneal bladder rupture. The chapter provides a comprehensive and outlined method of demonstrating how to diagnose, treat, and follow-up patients with GU trauma.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 59.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 79.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Similar content being viewed by others

References

  1. Santucci RA, Wessells H, Bartsch G, Descotes J, Heyns CF, McAninch JW, Nash P, Schmidlin F (2004) Evaluation and management of renal injuries: consensus statement of the renal trauma subcommittee. BJU Int 93:937–954

    Article  CAS  PubMed  Google Scholar 

  2. Kuan J, Wright J, Nathens A, Rivara F, Wessells H (2006) American Association for the Surgery of Trauma: American Association for the Surgery of Trauma Organ Injury Scale for kidney injuries predicts nephrectomy, dialysis, and death in patients with blunt injury and nephrectomy for penetrating injuries. J Trauma 60:351–356

    Article  PubMed  Google Scholar 

  3. Cass A (1989) Renovascular injuries from external trauma. Diagnosis, treatment, and outcome. Urol Clin North Am 16:213

    CAS  PubMed  Google Scholar 

  4. Buckley JC, McAninch JW (2011) Revision of current American Association for the Surgery of Trauma Renal Injury grading system. J Trauma Acute Care 70(1):35

    Article  Google Scholar 

  5. McAninch JW, Carroll PR (1982) Renal trauma: kidney preservation through improved vascular control-a refined approach. J Trauma 22:285

    Article  CAS  PubMed  Google Scholar 

  6. Brewer ME, Strnad BT, Daley BJ, Currier RP, Klein FA, Mobley JD, Kim ED (2009) Percutaneous embolization for the management of grade 5 renal trauma in hemodynamically unstable patients: initial experience. J Urol 181:1737–1741

    Article  PubMed  Google Scholar 

  7. Hotaling JM, Sorensen MD, Smith TG III, Rivara FP, Wessells H, Voelzke BB (2011) Analysis of diagnostic angiography and angioembolization in the acute management of renal trauma using a national data set. J Urol 185:1316–1320

    Article  PubMed Central  PubMed  Google Scholar 

  8. Alsikafi NF, McAninch JW, Elliott SP, Garcia M (2006) Nonoperative management outcomes of isolated urinary extravasation following renal lacerations due to external trauma. J Urol 176:2494–2497

    Article  PubMed  Google Scholar 

  9. Tasian GE, Aaronson DS, McAninch JW (2010) Evaluation of renal function after major renal injury: correlation with the American Association for the Surgery of Trauma Injury Scale. J Urol 183:196–200

    Article  PubMed  Google Scholar 

  10. Santucci RA, McAninch JW, Safir M, Mario LA, Segal MR (2001) Validation of the American Association for the Surgery of Trauma organ injury severity scale for the kidney. J Trauma Acute Care 50:195–200

    Article  CAS  Google Scholar 

  11. Perez-Brayfield MR, Keane TE, Krishnan A, Lafontaine P, Feliciano DV, Clarke HS (2001) Gunshot wounds to the ureter: a 40-year experience at Grady Memorial Hospital. J Urol 166:119

    Article  CAS  PubMed  Google Scholar 

  12. Schuster TG, Hollenbeck BK, Faerber GJ, Wolf JS Jr (2001) Complications of ureteroscopy: analysis of predictive factors. J Urol 166:538–540

    Article  CAS  PubMed  Google Scholar 

  13. Dowling R, Corriere J Jr, Sandler C (1986) Iatrogenic ureteral injury. J Urol 135:912

    CAS  PubMed  Google Scholar 

  14. Townsend M, DeFalco AJ (1995) Absence of ureteral opacification below ureteral disruption: a sentinel CT finding. AJR 164:253–254

    Article  CAS  PubMed  Google Scholar 

  15. Parry NG, Rozycki GS, Feliciano DV, Tremblay LN, Cava RA, Voeltz Z, Carney J (2003) Traumatic rupture of the urinary bladder: is the suprapubic tube necessary? J Trauma Acute Care 54:431–436

    Article  Google Scholar 

  16. Chan DP, Abujudeh HH, Cushing GL, Novelline RA (2006) CT cystography with multiplanar reformation for suspected bladder rupture: experience in 234 cases. AJR 187:1296–1302

    Article  PubMed  Google Scholar 

  17. Volpe MA, Pachter EM, Scalea TM, Macchia RJ, Mydlo JH (1999) Is there a difference in outcome when treating traumatic intraperitoneal bladder rupture with or without a suprapubic tube? J Urol 161:1103–1105

    Article  CAS  PubMed  Google Scholar 

  18. Deibert CM, Spencer BA (2011) The association between operative repair of bladder injury and improved survival: results from the National Trauma Data Bank. J Urol 186:151–155

    Article  PubMed  Google Scholar 

  19. Kim FJ, Chammas MF Jr, Gewehr EV, Campagna A, Moore EE (2008) Laparoscopic management of intraperitoneal bladder rupture secondary to blunt abdominal trauma using intracorporeal single layer suturing technique. J Trauma Acute Care 65:234–236

    Article  Google Scholar 

  20. Pompeo A, Sehrt D, Costa RM, Juliano C, Phillips JM, Molina WR, Stahel PF, Moore EE, Kim FJ (2013) Success rate of primary urethral realignment is independent of the severity of pelvic trauma after total posterior urethral disruption. J Urol [Epub ahead of print]

    Google Scholar 

  21. Mouraviev VB, Coburn M, Santucci RA (2005) The treatment of posterior urethral disruption associated with pelvic fractures: Comparative Experience of early realignment versus delayed urethroplasty. J Urol 173:873–876

    Article  PubMed  Google Scholar 

  22. Yu J, Xu Y, Qiao Y, Gu B (2007) Urethral cystoscopic realignment and early end-to-end anastomosis develop different influence on erectile function in patients with ruptured bulbous urethra. SBiRM 53:59–62

    CAS  Google Scholar 

  23. Bjurlin MA, Fantus RJ, Mellett MM, Goble SM (2009) Genitourinary injuries in pelvic fracture morbidity and mortality using the National Trauma Data Bank. J Trauma 67:1033

    Article  PubMed  Google Scholar 

  24. Dorairajan G, Rani PR, Habeebullah S, Dorairajan LN (2004) Urological injuries during hysterectomies: a 6‐year review. J Obstet Gynaecol Res 30:430–435

    Article  PubMed  Google Scholar 

  25. Bitsch M, Kromann-Andersen B, Schou J (1990) The elasticity and the tensile strength of tunica albuginea of the corpora cavernosa. J Urol 143:642–645

    CAS  PubMed  Google Scholar 

  26. Zoargooshi J (2000) Penile fracture in Kermanshah, Iran: report of 172 cases. J Urol 164:364–366

    Article  Google Scholar 

  27. Asgari MA, Hosseini SY, Safarinejad MR, Samadzadeh B, Bardideh AR (1996) Penile fractures: evaluation, therapeutic approaches and long-term results. J Urol 155:148–149

    Article  CAS  PubMed  Google Scholar 

  28. Cass A (1983) Testicular trauma. J Urol 129:299

    CAS  PubMed  Google Scholar 

  29. Wasko R, Goldstein AG (1966) Traumatic rupture of the testicle. J Urol 95:721–723

    CAS  PubMed  Google Scholar 

  30. Buckley JC, McAninch JW (2006) Use of ultrasonography for the diagnosis of testicular injuries in blunt scrotal trauma. J Urol 175:175–178

    Article  PubMed  Google Scholar 

  31. Kim SH, Park S, Choi SH, Jeong WK, Choi JH (2009) The efficacy of magnetic resonance imaging for the diagnosis of testicular rupture: a prospective preliminary study. J Trauma Acute Care 66:239–242

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Division of Urology, Department of Surgery, University of Colorado Hospital, School of Medicine, 12631 E 17th Ave, M/S C-319, Academic One Office Building, Aurora, CO, 80045, USA

    Vassilis J. Siomos

  2. Division of Urology, Department of Surgery, Denver Health Medical Center, 777 Bannock Street, MC 0206 (Urology), Denver, CO, 80204, USA

    David Sehrt

  3. Division of Urology, Department of Surgery, Denver Health Medical Center, University of Colorado Denver, 777 Bannock Street, MC 0206 (Urology), Denver, CO, 80204, USA

    Fernando J. Kim MD, FACS

Authors
  1. Vassilis J. Siomos
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. David Sehrt
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Fernando J. Kim MD, FACS
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Fernando J. Kim MD, FACS .

Editor information

Editors and Affiliations

  1. Trauma Surgery Unit, Maggiore Hospital, Bologna, Italy

    S. Di Saverio

  2. Trauma Surgery Unit, Maggiore Hospital, Bologna, Italy

    G. Tugnoli

  3. Emergency and Trauma Surgery, Maggiore Hospital, Parma, Italy

    F. Catena

  4. General and Emergency Surgery, Papa Giovanni XXIII Hospital, Bergamo, Italy

    L. Ansaloni

  5. Surgery, Port Shepstone Regional Hospital, Durban, South Africa

    N. Naidoo

15.1 Electronic Supplementary Material

Below is the link to the electronic supplementary material.

(ZIP 4.70 MB)

Rights and permissions

Reprints and permissions

Copyright information

© 2014 Springer-Verlag Italia

About this chapter

Cite this chapter

Siomos, V.J., Sehrt, D., Kim, F.J. (2014). Surgical Treatment of Kidney and Urinary Tract Trauma. In: Di Saverio, S., Tugnoli, G., Catena, F., Ansaloni, L., Naidoo, N. (eds) Trauma Surgery. Springer, Milano. https://doi.org/10.1007/978-88-470-5459-2_15

Download citation

  • DOI: https://doi.org/10.1007/978-88-470-5459-2_15

  • Published:

  • Publisher Name: Springer, Milano

  • Print ISBN: 978-88-470-5458-5

  • Online ISBN: 978-88-470-5459-2

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation