[Injuries of the renal pelvis and ureter. Diagnosis and management]
M Trottmann1, S Tritschler, A Graser
1Urologische Klinik und Poliklinik, Klinikum der Ludwig-Maximilians-Universität München-Grosshadern, 81377, München. matthias.trottmann@med.uni-muenchen.de
Abstract:
About 5% of injuries of the urinary tract affect the renal pelvis and ureter and constitute a severe complication. Around 75% of these injuries are iatrogenic and only about 25% are caused by blunt abdominal trauma or perforation. To avoid complications and improve prognosis, immediate diagnosis and therapy are essential. The diagnostic accuracy of preoperative studies is low, therefore frequently injuries are detected during explorative laparotomy. The management of upper urinary tract lesions depends on severity and localization, whereas the ultimate ambition should always be the preservation of the kidney. As a basic rule, ureteral stenting is mostly sufficient for small lesions, and only larger injuries require open reconstructive techniques. Longitudinal studies document a high degree of functional reconstitution if adequate and immediate treatment is carried out.
Related Concept Videos
Urinary Tract Calculi III: Medical Management
Urinary Tract Calculi V: Nursing Management
Acute Pyelonephritis II: Diagnostic Studies and Management
Urinary Tract Calculi VI: Surgical Management
Imaging Studies V: Intravenous Urography and Retrograde Pyelography
Urinary Tract Calculi II: Pathophysiology and Clinical Manifestations

