Injuries of the urino-genital organs

In modern emergency situations of peacetime and in local military conflicts, 20% of the injured have trauma to the genitourinary organs.

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

Damage - a violation of the integrity of the structure of the body as a result of adverse effects of external factors, i.e. This category is pathomorphological. One victim may have several injuries. Each damage has a specific cause and mechanogenesis of formation. From the foregoing, it follows that health professionals deal with injuries, not injuries.

[1], [2], [3]

General features of genitourinary injuries

Along with the common features characteristic of damages of any location, trauma to the genitourinary organs have a number of characteristics.

In the mechanogenesis of damage to organs containing urine, an essential role belongs to the so-called hydrodynamic impact, i.e. The rupture of their walls occurs due to a sharp displacement of the liquid in it.

The frequency of iatrogenic lesions (for example, the urethra with catheterization of the bladder or ureter during gynecological operations) is fairly high.

Common symptoms of genitourinary injuries are hematuria, urethrorrhagia, urination disorders and urinary excretion from the wound.

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

Physical examination of the patient, as a rule, does not allow to determine the type, nature and severity of damage to the genito-urinary organs.

In the treatment of patients with injuries of the urogenital organs, there is almost always a question of the need for urinary diversion.

Some long-term consequences of damage to the genitourinary organs can be of high social significance for the patient (urinary fistula, erectile dysfunction, secondary infertility and other diseases).

Classification of injuries of the urino-genital organs

Damage to the genito-urinary organs, depending on the integrity of the skin, is divided into closed (subcutaneous or blunt) and open (penetrating or injured). With open damage to the kidneys, the risk of infectious and inflammatory complications increases substantially.

Damage to the organs of the genitourinary system can be isolated and combined (that is, accompanied by injuries to other organs), as well as single and multiple (by the number of wounds). Combined and multiple injuries of the genito-urinary organs are accompanied by a severe condition of the patient and, as a rule, require the specialists of various profiles to treat joint actions.

Damage to the paired urogenital organs can be one- and two-sided.

In terms of severity - light, medium and heavy.

Depending on the presence of complications, the damage can be complicated and 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.

[4], [5], [6], [7]