Urinary tract (including kidneys, ureters, bladder and urethra) may be traumatized because of penetrating injuries (stab), blunt trauma, radiation therapy and surgery.
Symptoms are most commonly found is the presence of blood in the urine (hematuria), decreased urination and painful process. Some blunt trauma can cause pain, swelling, bruising, and if sufficiently severe, can lower blood pressure (shock).
Metabolic wastes should be filtered from the blood by the kidneys and excreted through the urinary tract, therefore every injury that affects the process can be fatal. Prevent permanent damage to the urinary tract and prevent death depends on the diagnosis and appropriate treatment.
RENAL TRAUMA
Blunt trauma often causes injury to the kidney, such as motor vehicle accidents, falls or trauma during exercise. Stab wound to the kidney can be due to gunshot or stab wounds. The damage varies. Minor injuries cause hematuria that can only be determined by microscopic examination, whereas severe injuries may cause hematuria that appear as reddish-colored urine.
If the kidneys are severely injured, bleeding can occur and the urine can seep into surrounding tissue. If the kidney to separate from the stalk that contains veins and arteries, there can be bleeding, shock and death.
Trauma caused by ESWL (extracorporeal shock wave lithotripsy, a routine procedure to destroy kidney stones) can lead to the discovery of blood in the urine is temporary, not too obvious and would get better by itself, without any special treatment. X-ray examinations for kidney and urinary tract, such as intravenous urography and CT scan, can accurately determine the location and extent of injury.
Treatment begins with measures to control blood loss and prevent shock. Given intravenous fluids to normalize blood pressure and stimulate the formation of urine. For minor injuries (eg due to ESWL therapy), conducted surveillance of patients undergoing fluid intake and bed rest. Severe injuries that cause severe bleeding or leakage of urine into the surrounding tissue must often be corrected with surgery.
If blood flow to the kidneys decreases, then the normal kidney tissue can die and be replaced by scar tissue. This can cause high blood pressure that occurs within a few weeks or several months after the trauma. Typically if diagnosed and treated appropriately and quickly, then most of the renal trauma have a good prognosis.
TRAUMA ureter
Most of the trauma of the ureter (the tube from the kidney to the bladder) occurred during abdominal surgery or pelvic organs, such as hysterectomy, colon resection or uteroskopi. Often urine leaks from the wound which is formed or reduced production of urine. Symptoms are usually nonspecific and may develop a fever or pain.
Other causes of penetrating trauma is injury to the ureter, usually due to gunshot wounds. Trauma to the ureter is rare and injuries due to blunt blows. Diagnostic tests are usually done is an intravenous urography, CT scan and retrograde urography.
If the ureter caused by surgical trauma, then performed another surgery to repair the ureter. The ureter can be connected back to its original place in the bladder or the other. In the trauma that is not too heavy, mounted catheter into the ureter and left for 2-6 weeks so do not need surgery. The best treatment for ureteral trauma caused by gunshot wounds or stab wounds were surgically.
BLADDER TRAUMA
Impact trauma to the pelvis causing broken bones (fractures) often occur in a motorcycle accident and can cause a tear in the bladder. Penetrating injuries, usually caused by fire, can also injure the bladder. The main symptom is the presence of blood in the urine or difficulty urinating.
Diagnosis based on examination sistografi. Small tears (lacerations) can be overcome by inserting a catheter into the urethra to remove urine for 7-10 days and the bladder will get better by itself.
For more severe wounds, surgery is usually performed to determine the extent of injury and to repair any tears. Furthermore, urine from the bladder removed by using two catheters, one inserted through the urethra (trans-urethral catheter) and the other is plugged directly into the bladder through the lower abdomen (suprapubic catheter). Catheter was placed for 7-10 days or removed after the bladder has the perfect cure.
TRAUMA urethra
The main cause of trauma to the urethra is due to a broken pelvis and both legs spread (in men). Surgical procedures on the urethra or appliance that is inserted into the urethra can also injure the urethra, but the wound is relatively mild. Symptoms include blood found at the tip of the penis, hematuria and urinary disorders. Sometimes the urine seeps into the tissues in the abdominal wall, scrotum or perineum (the area between the anus and vulva or scrotum).
Narrowing of the ureter (stricture) in the affected area is usually a complication that can occur later in life. This can lead to impotence due to damage arteries and nerves of the penis. Diagnosis based on uretrogram retrograde.
Treatment for mild bruising is inserting a catheter through the urethra into the bladder for several days to remove the urine and the urethra will get better by itself. For other injuries, spending urine from the urethra is done by placing a catheter directly into the bladder. For the structure of the urethra performed surgical repair.
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