FEBRUARY 2024
Management of urologic injuries, including renal trauma, bladder trauma, and urethral trauma
1Dr Muhammad Hassan Siddiqui, 2Muhammad Adnan Sarwar, 3Farhan Khan, 4Dr Taimoor, 5Dr. Shaiq Ur Rehman, 6Dr Muhammad Mashkoor Aslam
1Dept of Urology, Ward 19, JPMC Karachi
2Senior Registrar, Department of Urology and Transplantation, Bahawal Victoria Hospital Bahawalpur
3Assistant Professor of Urology, Bilawal Medical College for Boys, LUMHS Jamshoro
4Urology Department, Senior Registrar at Creek General Hospital (UMDC), Karachi
5Medical Officer, Urology department, Kidney Centre, Bahawal Victoria Hospital Bahawalpur
6Senior Registrar, Department: Urology, Shahida Islam Teaching Hospital, Lodhran,
ABSTRACT
Background: The study emphasizes the importance of prompt and accurate diagnosis to prevent complications and improve patient outcomes. The study explores the evaluation and management of urologic injuries, with a specific focus on renal trauma, bladder trauma, and urethral trauma.
Methods: To validate the grading of renal trauma, a thorough evaluation was conducted on all cases provided by participating centers, specifically those accompanied by radiology images. The subsequent management strategies were categorized into three groups: expectant management, involving observation; conservative management, employing minimally invasive, endoscopic, or percutaneous procedures; and operative management, encompassing renal-associated surgical interventions.
Results: The average age of the patients was 34 years, having an interquartile range of 24 to 49. Blunt trauma was observed in 25 individuals, accounting for 93% of the cases. Among the patients, 12 (52%) underwent operative management, specifically nephrectomy. Conservative management was employed in nine individuals (38%), with seven receiving angioembolization and three having a stent or drainage tube inserted. Expectant management was chosen for seven patients (35%).
Conclusion: The discussion includes
an overview of the types and causes of these injuries, along with their clinical presentations and diagnostic approaches. Various treatment modalities are discussed, including conservative management, surgical interventions, and minimally invasive procedures.
Keywords: Urologic Injuries, Renal Trauma, Bladder Trauma, and Urethral Trauma.