Trauma to the genitourinary organs

In modern emergency situations during peacetime and local military conflicts, 20% of victims suffer injuries to the genitourinary organs.

The terms "urogenital trauma" and "damage" cannot be considered synonymous. They carry different semantic load. Trauma is not only a clinical category, but also a social one. Trauma of the urogenital organs is always one, although it can have different qualitative and quantitative characteristics. In trauma, it is always possible to identify a set of cause-and-effect relationships - pathogenesis. According to the conditions of occurrence, trauma is divided into domestic, street, sports, industrial, automobile, combat, etc.

Damage is a violation of the integrity of the organ structure as a result of adverse effects of external factors, i.e. this is a pathomorphological category. One victim may have several injuries. Each injury has a specific cause and mechanogenesis of formation. From the above it follows that medical workers deal with injuries, not trauma.

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General features of injuries of the genitourinary organs

Along with the general features characteristic of injuries of any localization, injuries to the genitourinary organs have a number of features.

In the mechanogenesis of damage to organs containing urine, a significant role is played by the so-called hydrodynamic shock, i.e. the rupture of their walls occurs due to the sharp displacement of the liquid contained in it.

The incidence of iatrogenic injuries is quite high (for example, of the urethra during catheterization of the bladder or the ureter during gynecological operations).

Common symptoms of genitourinary injuries include hematuria, urethrorrhagia, urinary disorders, and urine leakage from the wound.

Damage to the genitourinary system is rarely isolated. In severe combined damage to the genitourinary system, abdominal organs, retroperitoneal space, pelvis, the clinical picture is dominated by symptoms of shock, internal bleeding, peritonitis, etc. Such patients are usually hospitalized in intensive care units, as well as trauma and surgical departments. In such situations, the urologist acts as a consultant. His task is to suspect damage to the genitourinary organs and initiate special studies that allow not only to confirm the fact of damage, but also to determine its type, localization and severity, as well as to plan treatment tactics.

Physical examination of the patient, as a rule, does not allow determining the type, nature and severity of damage to the genitourinary organs.

When treating patients with injuries to the genitourinary organs, the question of the need for urine diversion almost always arises.

Some remote consequences of damage to the genitourinary organs can have high social significance for the patient (urinary fistulas, erectile dysfunction, secondary infertility and other diseases).

Classification of injuries of the genitourinary organs

Damage to the genitourinary organs, depending on the integrity of the skin, is divided into closed (subcutaneous or blunt) and open (penetrating or wounds). With open kidney damage, the risk of infectious and inflammatory complications increases significantly.

Damage to the genitourinary system can be isolated and combined (i.e. accompanied by damage to other organs), as well as single and multiple (by the number of wounds). Combined and multiple damage to the genitourinary organs is accompanied by a serious condition of the patient and, as a rule, requires joint actions of specialists of various profiles during treatment.

Damage to paired genitourinary organs can be unilateral or bilateral.

By severity - mild, moderate and severe.

Depending on the presence of complications, injuries can be complicated or uncomplicated.

In addition, for each specific organ of the genitourinary system there is a classification that takes into account the morphological features of its damage.

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