1. GENITOURINARY TRACT
TRAUMA
Héctor Eduardo Velázquez
Domínguez

2. KIDNEY INJURY

3. Kidney Injury
• Usually accompanied by mulJsystem trauma
• Work, sport, car accident
• ContusionlaceraJon/renal pedicule fracture

4. Clinical manifestaJons
• Hematuria
• Pain and hypersensiJvity
• Palpable mass

5. Imaging study
• RxRetroperitoneal hematoma/urinary
extravasaJon
• Excretory urogram
• TAC with IV contrast

6. ComplicaJons/TX
• Hemorrhage/shockstop bleeding and
volume replacement
• Progressive hydronephrosis
• Abscess

7. URETER INJURY

8. Ureter injury
Iatrogenic:
• Pelvic surgery
PenetraJng trauma

9. Clinical manifestaJon
• Anuria and oliguria
• Ileus
• Pain
• Drainage to adjacent
structures
• ¡Hydronephrosis!

10. Dx
• Excretory urogram
• Retrograde
uretherography
• ECO
• TAC

11. Tx
Ureteral division:
• Ureteroureterostomía
• Neoureterocistostomía
• Transureteroureterostom
ía
Ureteral resecJon
• Ureteral replacement
• Tie bladder to psoas
• Autotransplant
• IntesJnal

12. BLADDER INJURY

13. Bladder injury
• Direct trauma
• Pelvic fracture
• Pelvic surgery
• Cystoscopy
• Intraperitoneal (40%)
• Extraperitoneal (54%)

14. Clinical manifestaJon
• Suprapubic pain
• Hematuria
• Inhability to urinate
• Intraperitoneal=peritoni
Js

15. Dx/Tx
• Rx
• Cystography
• Excretory urogram
• Surgery

16. URETRA INJURY

17. Uretra injury
• Anterior or posterior
• Hematuria, pain,
inhability to urinate
• Hematoma, InfecJon,
fibrosis, erecJle
dysfuncJon

18. THANK YOU