Urinary Tract Trauma

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