Urotrauma: AUA Guideline

Morey, Allen F.; Brandes, Steve; Dugi, Daniel; Armstrong, John H.; Breyer, Benjamin N.; Broghammer, Joshua A.; Erickson, Beth; Holzbeierlein, Jeff M.; Hudak, Steven J.; Pruitt, Jeffrey H.; Reston, James; Santucci, Richard A.; Smith, Thomas G.; Wessells, Hunter

doi:10.1016/j.juro.2014.05.004

Cited by 492 publications

(534 citation statements)

References 114 publications

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“…Renal injury occurs in up to 5% of trauma patients, and accounts for 24% of traumatic abdominal solid organ injuries [1]. Blunt injury accounts for 80 to 95% of renal injury trauma in the United States [2].…”

Section: Introductionmentioning

confidence: 99%

Management of High-grade Blunt Renal Trauma

Lee

Jang

Lee

2017

Journal of Trauma and Injury

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Purpose: Blunt injury accounts for 80-95% of renal injury trauma in the United States. The majority of blunt renal injuries are low grade and 80-85% of these injuries can be managed conservatively. However, there is a debate on the management of patients with high-grade renal injury. We reviewed our experience of renal trauma at our trauma center to assess management strategy for high-grade blunt renal injury. Methods: We reviewed blunt renal injury cases admitted at a single trauma center between August 2007 and December 2015. Computed tomography (CT) scan was used to diagnose renal injuries and high-grade (according to the American Association for the Surgery of Trauma [AAST] organ injury scale III-V) renal injury patients were included in the analysis. Results: During the eight-year study period, there were 62 AAST grade III-V patients. 5 cases underwent nephrectomy and 57 underwent non-operative management (NOM). There was no difference in outcome between the operative group and the NOM group. In the NOM group, 24 cases underwent angioembolization with a 91% success rate. The Incidence of urological complications correlated with increasing grade. Conclusions: Conservative management of high-grade blunt renal injury was considered preferable to operative management, with an increased renal salvage rate. However, high-grade injuries have higher complication rates, and therefore, close observation is recommended after conservative management.

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Section: Introductionmentioning

confidence: 99%

Management of High-grade Blunt Renal Trauma

Lee

Jang

Lee

2017

Journal of Trauma and Injury

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“…The stent will typically remain in situ for 4-6 weeks and will be removed after imaging studies confirm a patent anastomosis with no leak. The drain will be removed after confirmation of a leak-free anastomosis 11,23,24) .…”

Section: Repair Of Ureteral Injuriesmentioning

confidence: 99%

“…The ureter can then be tunneled in either an intra-or extravesical fashion, as described earlier. A ureteral stent is placed and the anterior cystotomy is closed in a vertical fashion 11,23,24) .…”

Section: Distal Ureteral Injuriesmentioning

confidence: 99%

“…The latter involves raising the anterior bladder wall in a rectangular fashion and anchoring to the psoas tendon, as described earlier. The vascular supply of this flap is based on the ipsilateral superior vesical artery 11,23,24) .…”

Section: Midureteral Injuriesmentioning

confidence: 99%

“…Crohn's disease and radiation enteritis are contraindications to this approach. In patients with very extensive severe injuries, a percutaneous nephrostomy or nephrectomy may be considered 11,23,24) .…”

Section: Proximal Ureteral Injuriesmentioning

confidence: 99%

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Ureteral Injury During Colorectal Surgery: Two Case Reports and a Literature Review

Yellinek

Krizzuk

Nogueras

et al. 2018

J Anus Rectum Colon

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Abstract:Iatrogenic ureteral injury (IUI) is a dreaded complication of abdominopelvic surgery. Although rare, it is associated with severe consequences. This complication most commonly occurs during gynecological procedures but may also occur during colorectal surgeries. We present two cases of IUI in patients in whom the ureteric stents were electively placed. The first case was a 71-year-old male with no significant medical history. The patient underwent an elective laparoscopic sigmoidectomy for complicated diverticulitis. During the procedure, a proximal IUI occurred, and was recognized and repaired. The second case occurred in a 68-year-old male with a history of multiple complicated abdominal surgeries. The patient underwent a second redo low anterior resection for a long preanastomotic stricture. The IUI occurred in the right fibrosed presacral plane, approximately 3 cm proximal to the bladder. The ureter was reimplanted to the bladder during the same procedure. We will also present a literature review of IUI, including the risk factors, intraoperative prevention, and repair options.

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Blunt Renal Injuries

Hampson¹,

Mmonu²

2021

A Clinical Guide to Urologic Emergencies

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Urotrauma: AUA Guideline

Cited by 492 publications

References 114 publications

Management of High-grade Blunt Renal Trauma

Management of High-grade Blunt Renal Trauma

Ureteral Injury During Colorectal Surgery: Two Case Reports and a Literature Review

Blunt Renal Injuries

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