Management of genitourinary trauma

The spectrum of genitourinary injuries seen in a small community hospital over the past three years is presented. With the exception of the obvious ureteral injury, the key factor in management is adequate x-ray diagnosis. This allows the physician to estimate the type and extent of injury. In the clinically stable patient, renal injuries can be managed conservatively. However, in our experience a major renal injury is usually associated with major intra-abdominal injury and these patients require exploration. Bladder injuries may be diagnosed with a cystogram, and repaired. Posterior urethral injuries may be managed initially by simple insertion of a suprapubic tube.