Urologic Trauma

Question 1

Most common organ involved in génito-urinary trauma

Answer 1

Kidney

Question 2

Type of injury in genitourinary system

Answer 2

Penetrating
Blunt

Question 3

Location of injuries that should alert about possible renal injury

Answer 3

Upper abdomen
Lower chest

Question 4

Which part of the body should be immmobilized in trauma until confirmed intact by radiography

Answer 4

Cervical spine immobilization

Question 5

Signs during examination that suggest possible renal injury

Answer 5

Flank hematoma
Abdominal/ flank tenderness
Rib fractures
Penetrating injuries to low thorax

Question 6

Grade of kidney injury in trauma

Answer 6

Grade I - subscapular I Hematoma or contusion
Grade II- Perirenal hematoma
Grade III- Vascular injury or active hemorrhage confined to perinephric facia
Grade IV- segmental vein or artery injury, Laceration with pelvic involvement, Active bleed beyond perinephric fascia, segMental or complete infarct

Grade V- Shattered kidney, lacerated artery or vein, desvascularized kidney with acute bleeding

Question 7

Imaging used to facilitate Reppy diagnosis of intra-abdominal injuries

Answer 7

Sonography at high frequency

Question 8

See guide for renal injuries

Question 9

Common causes of ureteral injuries

Answer 9

External trauma
open surgery
laparoscopy
endoscopic procedures
Intraoperative suture ligation
sharp incision and transection
avulsion
devascularization
heat
Freezing

Question 10

See grading of ureter injury

Question 11

2 types bladder injuries

Answer 11

Extraperitoneal bladder injury
intraperitoneal injuries

Question 12

Main cause of extraperitoneal bladder injury

Answer 12

Pelvic fracture

Question 13

Main cause of intraperitoneal

Answer 13

penetrating injury, burst injuries due to blow to a full bladder
pelvic fracture

Question 14

Management bladder injury

Answer 14

Immediate catheterization in blunt bladder rupture

Retrograde urethrography if Blood at meatus or catheter does not pass easily

Question 15

Clinical indication of bladder injury

Answer 15

Suprapubic pain or tenderness
free intraperitoneal fluids on ct or ultrasound examination
inability to void/ low urine output
Clots in urine
clots in bladder on CT
Enlarged scrotum with ecchymoses
abdominal distention or ileus

Question 16

What is the treatment of uncomplicated extraperitoneal bladder rupture with ideal conditions

Answer 16

Conservative management with urethral catheter drainage alone

Question 17

Management of penetrating or intraperitoneal injuries due to external trauma

Answer 17

Immediate operative repair

Question 18

Causes of urethral injuries

Answer 18

In multisystem trauma from vehicular accidents , falls, or industrial accidents

Question 19

What is the triad of urethral disruption

Answer 19

Blood at meatus
inability to urinate
palpably full bladder

Question 20

Management of urethral disruption

Answer 20

Do not do urethral catheterization
Diversion of urine using formal cystostomy
delayed urethral reconstruction with anastomotic urethroplasty

Question 21

Penile fracture definition

Answer 21

Description of Tunica albuginea with rupture of corpus cavernosum

Question 22

Main cause of penile fracture

Answer 22

Vigorous sexual intercourse
masturbation
running over or falling onto the erect penis

Question 23

Diagnosis of penile fracture

Answer 23

History of cracking or popping sound
Pain
rapid détumescence
discoloration and swelling of penile shaft

Question 24

Other forms of penile trauma

Answer 24

Animal or human bites
genital self mutilation
zipper injuries