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Genitourinary Trauma Guide
1.
GENITOURINARY TRACT
TRAUMA Héctor Eduardo Velázquez Domínguez
2.
KIDNEY INJURY
3.
Kidney Injury • Usually accompanied by mulJsystem trauma • Work, sport, car accident •
ContusionlaceraJon/renal pedicule fracture
4.
Clinical manifestaJons • Hematuria • Pain and hypersensiJvity •
Palpable mass
5.
Imaging study • RxRetroperitoneal hematoma/urinary
extravasaJon • Excretory urogram • TAC with IV contrast
6.
ComplicaJons/TX • Hemorrhage/shockstop 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.
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