Injuries to the genitourinary tract or the reproductive organs, referred to as urotrauma, are seen often in case of impact injuries, falls and weapon injuries. These injuries can involve the organs, as well, including kidneys, ureters, uterus, bladder and genitalia. Urotrauma patients are often not able to urinate normally following injury. Therefore, they need immediate attention of a Urologist in Islamabad.

Read on to know more about urotrauma, its causes, symptoms, diagnosis and management:

What is urotrauma?

Urotrauma refers to injury to the reproductive organs, as well as, the urinary tract organs. In normal condition, the urinary tract produces urine in the kidneys, transfers it through the ureters into the urinary bladder, where it stores for some time and then gets excreted through the urethra and external genitalia. The opening of this urethra is at the end of the penis in men, and in front of the vagina in women. In men, the urethra is also responsible for the excretion of ejaculate containing the sperm.

Urotrauma can have a severe impact on a person’s ability to urinate and even normal sexual function.

What are the causes of urotrauma?

Urotrauma can occur secondary to:

  • Blunt trauma such as blows to the organs
  • Iatrogenic—during surgery
  • Injury due to falls particularly straddle injuries
  • Bullet wounds and stab wounds
  • Trauma due to accidents (for instance impact with car or bike)

What are the symptoms of urotrauma?

The symptoms of urotrauma include:

  • Pain in the pelvis
  • Pain in the abdomen
  • Pain in the lower back
  • Bloating of abdomen
  • Difficulty in urination or complete lack of urination especially if bladder or urethra are injured
  • Dehydration
  • Bruising in the involved areas
  • Blood in the urine, which is often the first indicator of urethral injury

If there is blood in the urine after a traumatic experience, it must be considered medical emergency and the patient must be rushed to the healthcare provider.

How is urotrauma diagnosed?

The diagnosis of urotrauma is based on thorough history and examination. The healthcare provider looks for the injury to the external genitalia and urethra to look for deep bruising, swelling in the abdomen, open wounds, signs of shock due to pelvic fracture and broken bones including ribs or pelvis.

Diagnostic investigations for particular organs involve:

  • Kidney trauma: renal trauma is best diagnosed with computed tomography (CT) done with contrast. The contrast helps to better see the organs in the pelvis and the kidneys.
  • Bladder trauma: this can be highlighted through use of retrograde cystogram, in which a contrast is injected into the bladder through the urethra and an x-ray is performed then. This investigation can delineate bladder injury and leakage of urine. 
  • Ureteral trauma: the ureters can be defined through retrograde pyelogram, in which x-ray is performed after contrast is given. CT urogram is also helpful in investigating ureteral trauma. For inconspicuous ureteral injury, laparotomy lets a surgeon look at the ureter in detail.
  • Urethral trauma: retrograde urethrography with x-ray makes detailed imaging of the urethra and is used in men who have severe pelvic injury.
  • Genital trauma: gross examination of the penis helps to look for injuries.

What are the treatment options?

In most cases of urotrauma, surgical repair is the ultimate treatment option. Depending on the extent of damage, surgical repair can be planned by the health teams—including trauma surgeons and urologists.

Treatment of kidney damage: in case of organ damage, there can be collection of blood or urine in the kidneys. The surgeon can repair the organ, remove the collected fluid and monitor the healing process. In case of organ failure, dialysis can help support kidney function.

Treatment of bladder trauma: bladder injuries are also surgically repaired. Until complete recovery, a catheter is used to remove urine from the bladder.

Treatment of ureteral trauma: ureters carry urine from the kidney to the bladder. Any injury to them needs surgical repair, and stents may have to be placed by the surgeon.

Treatment of genital trauma: In case of genital trauma, Urologist in Lahore aim to restore the urological and sexual function of the organ.