INJURIES OF THE URINARY SYSTEM - MANAGEME NT IN MULTIPLE TRAUMA PATIENTS

Some of the most common lesions in patients with multiple traumas are injuries to the urinary system. A blunt trauma of the abdomen mainly l eads to injuries of the kidney, ureter and/or bladder, whereas the ext ernal genitals are often damaged by contusions, decollements and even amputation. The multiply traumatized patient must necessarily be cared for and treated through an interdisciplinary cooperation. Thus, ''uro logisation'' of the condition must be avoided, as must the non-recogni tion of urological injuries. latrogenic lesions are primarily observed in the context of urological, gynecological and surgical intervention s. Immediate recognition may lead to early treatment, thereby avoiding possible, complications. The procedure for treating multiply traumati zed patients will be shown using a plan of specific steps. Symptoms of injuries to the genitourinary system are usually not obvious. In most cases micro-and macrohematuria are the leading symptoms, but they are not always demonstrable. In the acute phase the drainage of urine mus t be protected. It is mainly during the third step that urological les ions require surgical treatment. Catheterisation of the urethra may on ly be performed when the possibility of injury to it is excluded.