Trauma

Trauma in the urinary tract is quite uncommon. The trauma along the urinary tract can be divided into 3 basic categories depending upon the part where the injury or trauma has been received. The probability ratio of kidneys injury is 1:10 for every abdominal trauma, the bladder is protected by the pelvic bone. Thus only major impact injury can damage the bladder..

What are the different types of urinary tract trauma?

The three basic types of trauma or injury to the urinary system are as follows:

Renal Trauma

Renal trauma, though can be quite serious, are generally less severe than the injuries involving the other internal organs. Commonly caused by vehicular accidents and sports and similar activities. Next common injuries are due to stab injury due sharp objects and gun shot injuries. The most common sports injuries occur from cycling, horse riding, winter sports martial arts and the ones involving contact or collision.

Patient might have hematuria ( blood in the urine). A proper imaging like CT scan of the abdomen will give a exact estimate of severity of the injury. Conservative management is used for treatment in the less severe cases while surgery is reserved for high grade injuries.

Bladder Trauma

Though injuries to the bladder are uncommon, it can get injured by blows or other piercing objects. The bones of the pelvis protect the bladder. The top part only emerges when it is full. The pelvic bones are not fully developed in children and injuries can be pretty common. The most common causes include falling from high places, car crashes and heavy objects falling on the lower abdomen. Bladder trauma could also be caused by knives, bullets, IEDs and shrapnel.

The minor injuries are treated with catheters. While the major damages like intraperitoneal and extraperitoneal rupture needs surgery.

Urethral Trauma

Urethral trauma results when the urethra gets hurt by force. Trauma to the anterior urethra is common from straddle injuries like fall on cycle bar. Anterior urethra are also common in fracture of penis a blunt injury of penis while having intercourse. A trauma to the posterior urethra almost always involves a severe injury. The urethra might be completely torn away in males. The urethral injuries are rare in women and are linked to pelvic fractures, tears and cuts. The causes are similar to those causing bladder trauma.

If the injury is caused to the anterior urethra, it can be treated conservatively with a catheter. The scars formed by a blunt injury can result in stricture of the urethra much later date. These strictures can cause obstruction to the flow of urine. .Injuries to the posterior urethra turn out to be very complicated. It would almost always be associated with a major pelciv injuries. Most of the posterior urethral injuries would need an operation to reconnect the two torn edges.

Intervention

Complete assessment and early intervention saves the patients prevents complications.

Authored By : Dr. Mahendra Jain