Urinary Tract Trauma

  • Eduardo Zanchet
  • Mateus Belotte
  • Mariana F. Jucá Moscardi
  • Andrea Rachel Marcadis
  • Antonio Marttos


Only 43% of ureteral trauma cases present with hematuria, and therefore there are no pathognomonic signs of ureteral trauma. The diagnosis is usually performed by the visualization of contrast leakage into the retroperitoneum on helical computed tomography (CT) with late cuts. Excretory urography and retrograde pyelography are more precise exams. Grade I and II injuries can be treated by ureteral stent implantation or nephrostomy.

Isolated blunt bladder trauma is rare, and normally it is associated with pelvic fractures. Hematuria (occurs in 95% of cases), abdominal pain, inability to urinate, gross scrotal or perineal hematoma, and abdominal distention are the most common signs and symptoms. Diagnosis is generally made by retrograde cystography. Extraperitoneal injuries are usually treated by closed-system urethral catheterization. Intraperitoneal injuries require surgical exploration and correction.


Urinary tract trauma Ureteral trauma Bladder trauma Abdominal trauma Trauma Ureter Bladder 


  1. 1.
    Pereira BMT, Ogilvie MP, Rodriguez JCG, Ryan ML, Peña D, Marttos AC, Pizano LR, McKenney MG. A review of ureteral injuries after external trauma. Scand J Trauma Resusc Emerg Med. 2010;18:6.CrossRefGoogle Scholar
  2. 2.
    Lynch TH, Piñeiro LM, Plas E, Serafetinides E, Türkeri L, Santucci RA, Hohenfellner M. EAU guidelines on urological trauma. Eur Urol. 2005;47:1–15.CrossRefGoogle Scholar
  3. 3.
    Shewakramani S, Reed KC. Genitourinary trauma. Emerg Med Clin N Am. 2011;29:501–18.CrossRefGoogle Scholar
  4. 4.
    Santucci RA, Mcaninch JW. Bladder injuries: evaluation and management. Braz J Urol. 2000;26:408–14.Google Scholar
  5. 5.
    Rosenstein DI, Alsikafi NF. Diagnosis and classification of urethral injuries. Urol Clin N Am. 2006;33:73–85.CrossRefGoogle Scholar
  6. 6.
    Piñeiro LM, Djakovic N, Plas E, Mor Y, Santucci RA, Serafetinidis E, Turkeri LN, .Hohenfellner M. EAU guidelines on urethral trauma, Eur Urol 57 (2010) 791–803CrossRefGoogle Scholar
  7. 7.
    Tenke P, Kovacs B, Johansen TEB, Matsumoto T, Tambyahd PA, European NKG. Asian guidelines on management and prevention of catheter-associated urinary tract infections. Int J Antimicrob Agents. 2008;31S:S68–78.CrossRefGoogle Scholar

Copyright information

© Springer Nature Switzerland AG 2020

Authors and Affiliations

  • Eduardo Zanchet
    • 1
  • Mateus Belotte
    • 1
  • Mariana F. Jucá Moscardi
    • 2
  • Andrea Rachel Marcadis
    • 3
  • Antonio Marttos
    • 4
  1. 1.Department of Surgery, Hospital do Trabalhador Trauma Center, Federal University of ParanaCuritibaBrazil
  2. 2.Telemedicine and Trauma Research, University of Miami, Ryder Trauma CenterMiamiUSA
  3. 3.Department of Surgery, University of Miami, Miller School of Medicine, Jackson Memorial HospitalMiamiUSA
  4. 4.William Lehman Injury Research Center, Division of Trauma & Surgical Critical Care, Dewitt Daughtry Department of Surgery, Leonard M. Miller School of Medicine Miami, University of MiamiMiamiUSA

Personalised recommendations