Urological trauma

Kidney

Major trauma, unlikely to occur in isolation (check liver and spleen!) Ix CT + contrast. Will find:
  1. haematoma
  2. renal perfusion
  3. avulsed pedicle (no haematuria!)

Ureter

UK: surgical trauma. USA: gunshot, knife wound. Rx. stent.

Bladder

Extraperitoneal:
Surgical trauma (resection, cystocele), pelvic trauma. Δx cystography. ΔDelta;x ruptured urethra (DRE). Rx. catheter, conservative.

Intraperitoneal:
Catherisation, pelvic trauma. Peritonitis. Rx. surgical repair.

Urethra

Pelvic #, perineal trauma. Ix DRE (high riding prostate), contrast studies. Rx. suprapubic catheter, surgical repair.

Penis

# penis = ruptured tunica albuginea. Hx. trauma to erect penis, rapid detumescence. Rx. surgical repair to prevent future impotence.

Testis

Trauma unusual. US to look for rupture. Rx. surgical repair.