Presentation on theme: "Injuries to the Genitourinary Tract"— Presentation transcript:
1 Injuries to the Genitourinary Tract Dr. Kaveh MehravaranUrologist, Fellowship of Endourology & LaparoscopyHasheminejad Hospital
2 About 10% of all injuries seen in the emergency room involve the genitourinary system to some extent.The history should include a detailed description of the AccidentThe abdomen and genitalia should be examined for evidence of contusions or subcutaneous hematomas, which might indicate deeper injuries to the retroperitoneum and pelvic structures.Fractures of the lower ribs are often associated with renal injuries, and pelvic fractures often accompany bladder and urethral injuries.
3 Special Examinations Catheterization Computed tomography Retrograde cystographyUrethrographyArteriographyIntravenous urographyCYSTOSCOPYABDOMINAL SONOGRAPHY
7 INJURIES TO THE KIDNEYRenal injuries are the most common injuries of the urinary system.Kidneys with existing pathologic conditions such as hydronephrosis or malignant tumors are more readily ruptured from mild trauma.Blunt trauma directly to the abdomen, flank, or back is the most common mechanism, accounting for 80–85% of all renal injuries.
12 Treatment EMERGENCY MEASURES Blunt injuries:Cases in which operation is indicated include those associated with persistent retroperitoneal bleeding, urinary extravasation, evidence of nonviable renal parenchyma, and renal pedicle injuriesPenetrating injuriesTREATMENT OF COMPLICATIONS
13 INJURIES TO THE URETER Etiology SYMPTOMS SIGNS LABORATORY FINDINGS IMAGING FINDINGS
14 TreatmentThe best opportunity for successful repair is in the operating room when the injury occurs.If the injury is not recognized until 7–10 days after the event and no infection, abscess, or other complications exist, immediate reexploration and repair are indicated.Proximal urinary drainage by percutaneous nephrostomy or formal nephrostomy should be consideredif the injury is recognized late or if the patient has significant complications that make immediate reconstruction unsatisfactory.
15 INJURIES TO THE BLADDER Bladder injuries occur most often from external force and are often associated with pelvic fractures. (About 15% of all pelvic fractures are associated with concomitant bladder or urethral injuries.SYMPTOMSSIGNS