Genitourinary trauma

Genitourinary trauma occurs in up to 10% of all trauma cases and can be associated with significant morbidity and long-term complications if not managed appropriately. The majority of patients presenting with trauma will have had a CT trauma protocol scan which will guide management, but injuries are still missed and good clinical evaluation of the patient is crucial. Iatrogenic injuries, especially to the ureters, bladder and urethra, are common, and prompt recognition and management are vital to ensure a good outcome. The management of genitourinary trauma has shifted in recent years towards a more conservative approach. Interventional radiology offers excellent alternative management options in many cases. Where surgical exploration is indicated, the aims are to achieve haemostasis, debride necrotic tissue, but also to preserve as much functioning tissue as possible. This article outlines the incidence, investigation and management of trauma to the genitourinary system.