Urotrauma – What is it?
An injury to urinary tract or reproductive organs is termed as ‘Urotrauma’. The cause of the injury can be anything such as an accident, a fight, bad fall from a height hurting your abdominal area, consumption or breathing of chemicals, injury due a weapon/tool etc. If any of the organs in the abdomen area including kidneys, uterus, bladder, urethra or genitals are affected, such a medical condition is termed as ‘Urotrauma’. A person with Urotrauma may not be able to urinate properly or may not be able to reproduce.
What causes Urotrauma?
Urotrauma can be caused by any of the following incidents:
- When you get hit in your abdomen area by another person or vehicle or if you hit yourself to an object or fall from a height.
- Deep wound from a stab or a bullet.
- Injury to genitals caused by an object or a person or due to an accident
- Injury caused to any of these parts because of a surgery. (Medical errors can happen when the urologist is not well experienced.)
Symptoms of Urotrauma
Some symptoms can be felt due to the pain the injury causes and some can result in urological problems.
- Pain in pelvis region or lower back or abdomen or on the sides.
- Bruising or Swelling on your back or sides.
- Blood in urine
- Difficulty urinating or slow urination (when urethra or bladder are injured).
- Dehydration
- Belly bloating.
If you see blood in your urine, you must consider it as a medical emergency and rush to your nearest urologist or urogynecologist. Blood in urine can be caused due to several other problems along with Urotrauma. Your urologist will examine you carefully to figure out the actual cause of the problem.
Diagnosing Urotrauma
You must tell your doctor if anything unusual has happened such as a fight or accident etc. Then, your urologist will examine you to see if there is a swollen bladder or abdomen. He/she will look for any bruises or wounds that can indicate the parts that are affected, check for signs of bleeding or sometimes, if the pelvis bone(s) is/are cracked, that can cause severe problems.
He/She may ask you to get a CT Scan or X-ray of the pelvis region to get more information on the organs in the pelvis region. A CT Scan can reveal if there is any Renal (Kidney) damage or if any other organs in the pelvis region are damaged or injured. CT Scan also reveals the condition of the uterus along with X-ray. A retrograde cystogram is an x-ray that can reveal injuries to bladder, pelvis bones when you complain of blood in urine. A retrograde urethrography is another x-ray taken for men with injured penis or pelvis. Obviously, one or more of tests are advised after the physical examination. Physical examination will reveal if the external parts such as penis or scrotum is swollen or bruised or cracked.
Diagnosing Urotrauma
You must tell your doctor if anything unusual has happened such as a fight or accident etc. Then, your urologist will examine you to see if there is a swollen bladder or abdomen. He/she will look for any bruises or wounds that can indicate the parts that are affected, check for signs of bleeding or sometimes, if the pelvis bone(s) is/are cracked, that can cause severe problems.
He/She may ask you to get a CT Scan or X-ray of the pelvis region to get more information on the organs in the pelvis region. A CT Scan can reveal if there is any Renal (Kidney) damage or if any other organs in the pelvis region are damaged or injured. CT Scan also reveals the condition of the uterus along with X-ray. A retrograde cystogram is an x-ray that can reveal injuries to bladder, pelvis bones when you complain of blood in urine. A retrograde urethrography is another x-ray taken for men with injured penis or pelvis. Obviously, one or more of tests are advised after the physical examination. Physical examination will reveal if the external parts such as penis or scrotum is swollen or bruised or cracked.
Treating Urotrauma
Most of the times, Urotrauma will need surgical treatment. Treatment depends on which organs has been injured or damaged. As said, it can be any or mix of Kidney(s), ureters, bladder, urethra, pelvis bones or genitals. It is very important for you contact an experienced urologist or urogynecologist for your Urotrauma problems.
Treating Kidney (Renal)Trauma
In severe condition of Kidney damage, kidneys would be bleeding or the urine might have got collected in the kidneys. In such cases, the urologist can repair the kidney and monitor it’s healing process. The urine collected will also be removed. CT Scan will be required regularly during your hospital stay to monitor the recovery status of the kidney(s). If in case, a kidney fails, the other kidney will be able to take up the job of the other kidney. In cases where both the kidneys have problems, dialysis may be needed to support kidney functions.
You may need to stay in hospital for a good number of days until your urologist feels that the healing of kidneys is going well and you can be discharged.
Ureteral Trauma – Injury to the Ureter(s)
Surgery will be needed to repair the ureters. Ureters carry urine from kidneys to the bladder. If either or both of them are torn, the urologist will repair them. He/she may have to use stents depending on the actual condition of the ureters. The stents will carry the urine from kidneys to the bladder. In case of serious injuries, a percutaneous nephrostomy may be needed. In this procedure, a tiny catheter (tube) is inserted through the back to remove urine from the kidneys.
Bladder Trauma
If the bladder is injured, the urologist will fix it up with a surgery. During the healing process, a tube/catheter will be used to remove the urine from the bladder. Once the bladder is healed, the catheter will be removed.
Urethral Trauma
One must note that Urethra is different from Ureters. Urethra expel the urine from bladder. They also help in ejaculation for men. When the urethras are damaged, urine has to be removed from the bladder using a catheter until they are healed. This is the first task a professional urologist will perform when the urethra is damaged. This tube will be inserted through the abdomen by making a small incision. If the bones of the pelvis crack or break, it can damage the urethra. Recovery in such cases may take 3 to 6 months. The risk of the surgery to urethra is that it may cause erectile dysfunction or incontinence issues. The patient must take care of him/her self at least for a year, until the complete recovery happens.
Genital Trauma
When the genitals are damaged, the aim of the urologist will be get back the sexual and urological functions. If there is any injury to any organ, it will repaired during the surgery. If the penis is cracked, it has to be fixed as soon as possible, or if the penis is broken, the broken piece has to be put in saline and on ice. The fixing has to be done within hours else putting back the broken piece will not be possible. If the testicles are broken, they may have to be removed as soon as possible. If it is just the skin that is burnt, skin grafting needs to be done.
Post Treatment for Urotrauma
The patient will be under doctor’s care until he/she feels that the internal organs are healing well and the patient can be discharged to recover at home. Should there be any bleeding or problem with urine emptying, you should contact your urologist immediately. In all of these conditions , recovery will take time. The patient has to be very careful, in constant touch with the doctor and follow his/her advice with care.
