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Urology > Trauma > Flashcards

Trauma Flashcards

1
Q

what is class 1 kidney trauma?

A

Haematoma, subcapsular, non-expanding, no parenchymal laceration

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2
Q

what is class 2 kidney trauma?

A

laceration <1cm, parenchymal depth without urinary extravasation

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3
Q

what is class 3 kidney trauma?

A

> 1cm depth, no collecting system rupture or extravasation

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4
Q

what is class 4 kidney trauma?

A

 laceration through cortex, medulla and collecting system

 main arterial/venous injury with contained haemorrhage

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5
Q

what is class 5 kidney trauma?

A

shattered kidney, avulsion of hilum, devascularisation kidney

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6
Q

what are the causes of kidney trauma?

A

o Penetrating – gunshots, stab wounds
o Blunt – rapid deceleration, blow to flank
o Iatrogenic – extracorporeal shockwave, renal biopsy
o Intraoperative – diagnostic peritoneal lavage
o Other – renal transplant rejection, childbirth

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7
Q

what is the imaging used in kidney trauma?

A

CT

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8
Q

what are the indications for CT in kidney trauma?

A

o Frank haematuria in adult
o Frank or occult haematuria in child
o Occult haematuria in child
o Penetrating injury with any degree of haematuria

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9
Q

what is the management for kidney trauma?

A

o Most non-operatively

o Surgery – urinary extravasation or injury staging

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10
Q

what are the causes of bladder trauma?

A

o Blunt, penetrating, iatrogenic trauma

o Commonly associated with pelvic fracture

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11
Q

what is bladder contusion?

A

incomplete or partial thickness tear of bladder, produces haematoma

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12
Q

what is extra peritoneal bladder rupture?

A

coincides with pelvic fracture = deceleration, fracture of the anterior pubic arch

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13
Q

what are the clinical features of bladder trauma?

A

o Suprapubic tenderness, lower abdominal bruising, guarding/rigidity, diminished bowel sounds
o In catherization gross haematuria present

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14
Q

how is bladder trauma diagnosed?

A

CT cystography – extra peritoneal injury will have flame shaped collection in pelvis

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15
Q

what is the initial management of bladder trauma?

A

Large bore catheter antibiotics, repeat cystogram in 14 days

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16
Q

what are the indications for immediate repair in bladder trauma?

A

Intraperitoneal injury, penetrating injury, inadequate drainage or clots in urine, bladder neck, rectal or vaginal inury, open pelvic fracture, bone fragments

17
Q

what are the causes of urethral trauma?

A

o Blunt – blow to bulbar segment = straddling an object
o Penetrating – gunshot, stab wounds
o Iatrogenic – catheterisation

18
Q

what are the clinical features of urethral trauma?

A

blood at meatus, inability to urinate, palpably full bladder, high-riding prostate, butterfly perineal haematoma

19
Q

how is urethral trauma diagnosed?

A

retrograde urethrogram

20
Q

what is the management of urethral trauma?

A

suprapubic catheter, delayed reconstruction after 3 months

21
Q

what are the causes of penile fracture?

A

vaginal intercourse, aggressive masturbation

22
Q

what is the pathophysiology of penile fractures?

A

Tunica albuginea layer is violated – tear in this larger leads to extrusion of the seminiferous tubules and allows an intra-testicular haemorrhage to escape into the tunica vaginalis

23
Q

what are the clinical features of penile fractures?

A

cracking or popping sound, pain, rapid detumescence, discolouration and swelling

24
Q

what is the management of penile fracture?

A

prompt exploration and repair, circumcision incision with degloving of penis to expose 3 compartments

25
Q

what are the causes of testicular trauma?

A

o Blunt – sports
o Penetrating – gunshit/knife injury
o Degloving – machinery

26
Q

what is the pathophysiology of testicular injury?

A

Tunica albuginea layer is violated – tear in this larger leads to extrusion of the seminiferous tubules and allows an intratesticular haemorrhage to escape into the tunica vaginalis

27
Q

what are the clinical features of testicular trauma?

A

pain, nausea

28
Q

how is testicular trauma investigated?

A

US

29
Q

what is the management of testicular injury?

A

early exploration/repair improves testis, salvage, reduces convalescence, better preserves fertility and hormonal function

Urology (10 decks)

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