[Injuries of the urinary system and management in multiple trauma cases]

Some of the most common lesions in patients with multiple traumas are injuries to the urinary system. A blunt trauma of the abdomen mainly leads to injuries of the kidney, ureter and/or bladder, whereas the external genitals are often damaged by contusions, decollements and even amputation. The multiply traumatized patient must necessarily be cared for and treated through an interdisciplinary cooperation. Thus, "urologisation" of the condition must be avoided, as must the non-recognition of urological injuries. Iatrogenic lesions are primarily observed in the context of urological, gynecological and surgical interventions. Immediate recognition may lead to early treatment, thereby avoiding possible, complications. The procedure for treating multiply traumatized patients will be shown using a plan of specific steps. Symptoms of injuries to the genitourinary system are usually not obvious. In most cases micro- and macro-hematuria are the leading symptoms, but they are not always demonstrable. In the acute phase the drainage of urine must be protected. It is mainly during the third step that urological lesions require surgical treatment. Catheterisation of the urethra may only be performed when the possibility of injury to it is excluded.