Treatment is done to repair an injury, control symptoms and prevent more problems. Often, surgery is needed. It's important to find an experienced urologist for your care.
Based on the injury, you may need emergency surgery. If emergency care is needed, it may include a blood transfusion, IV fluids, or a hospital stay.
For Renal (Kidney) Trauma
The time you spend in the hospital will depend on your injury and how quickly your kidneys can recover.
If the kidneys are bleeding, damaged, or if urine pools in the body, surgery is needed. Surgery can repair the kidney and hopefully save them. The body is remarkable, so if one kidney is no longer able to function, the other can do the job of two.
A CT scan is done after surgery to make sure recovery is going well. If urine is leaking or if there are problems like fever, infection, or pain, you will need more care. Your doctor will need to remove urine from your body. They can use a ureteral stent (a tube inserted into the ureters). Or they can use a tiny catheter through your back (percutaneous nephrostomy) for this job.
Dialysis may be needed to help replace kidney functions. This could be used for a short time, or as a long-term solution. Once the body is stable, you can recover at home.
Some patients get high blood pressure from a major kidney trauma. This may be treated with medicine.
Get more information about renal trauma.
The ureters are tubes made of muscle to move urine from the kidneys to the bladder. If one or both are damaged, you will need surgery to repair them.
Imaging can help your urologist decide the best treatment
If there is a limited tear to the ureters, stents or surgery can fix the tear. Ureteral stents are tubes placed in the ureter to guide urine flow in the bladder. If the injury is more serious, a percutaneous nephrostomy may be needed.This places a tiny catheter through your back to remove urine from the kidneys. In some cases, open surgery will be done to repair as much as possible.
Some patients will need a period of recovery before surgery can be done to repair the ureter.
The bladder is the sac that holds urine in the body until it is released out of the body. If the bladder is damaged or bleeding from an injury, surgery can help. Surgery can repair a tear or allow urine to flow better.
Often, a catheter is used to drain the bladder until it heals. If surgery repairs the bladder, the catheter will be removed.
Get more information about bladder trauma.
The urethra's main job in males and females is to pass urine outside the body. This thin tube also has an important role in ejaculation for men. If it's damaged, your body will need help to urinate. If bones in the pelvis (the sacrum, coccyx, and hip bones) crack or break, it can damage the urethra. Trauma like this can also occur with straddle injuries or if an object pierces the sex organs.
For an emergency in which the pelvic bones are broken or the urethra is torn, a first step is to insert a suprapubic tube (SPT). This is a tube placed in the bladder through a cut below the belly button to drain urine. This can be used until the body can heal, or for longer. The SPT may be used for 3 to 6 months. After some time to heal from a pelvic fracture, it's easier to surgically connect torn edges of the urethra.
For some men, primary realignment (PR) is helpful if SPT is not. Surgery to repair the urethra in this way can be difficult. Your surgeon will want to limit scarring, erectile dysfunction (ED), and long-term incontinence.
Patients with urethral injuries will be watched carefully for at least one year after treatment. The hope is to avoid any scarring, incontinence, and for men, ED.
Learn more about urethral trauma.
Your care will be based on the injury to your genitals. The hope would be to repair sexual and urologic functions. The first step is to assess the problem and repair open wounds. If you don't have any open wounds, your doctor should check for internal problems.
If an ultrasound shows a penile fracture, surgery to repair the penis can help. If you are bleeding or can't pee, repair is crucial. Surgeons will want to work quickly to repair the penis. If the penis is cut off, the piece needs to be wrapped carefully in saline and placed on ice. Repair this way is only possible within hours of the injury.
For men, if the testicles are ruptured (broken) and cannot be saved, they may be removed (orchiectomy). The first goal would be to save the testicles. The sooner surgery can be done, the better.
For men or women, if the injury is from an infection or burns, the damaged skin will need to be removed and skin grafting may be needed.
Learn more information about penile trauma.
Updated December 2018