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Introduction to Genitourinary Tract Trauma

by Noel A. Armenakas, MD

The GU tract can be injured by blunt trauma (eg, motor vehicle crashes, falls) or penetrating trauma (eg, gunshot or stab wounds). Some injuries are caused during surgical procedures. Symptoms and signs are often subtle or nonspecific; therefore, diagnosis requires a high level of suspicion. Whenever urinalysis shows any hematuria in a patient with trauma, GU injury should be presumed until proved otherwise. Depending on the suspected site of injury, imaging studies, most often contrast-enhanced CT, are typically used to make a diagnosis. A rectal examination should be done in all patients who have blunt or penetrating trauma to the lower abdomen, pelvis, or perineum; presence of blood suggests concomitant bowel injury. General evaluation of the trauma patient is discussed elsewhere (see Approach to the Trauma Patient).

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