Preoperative radiographic staging for ureteral injuries is not warranted in patients undergoing celiotomy for trauma

Preoperative radiographic staging of the urinary tract has been shown to be inaccurate with regard to the ureter. The purpose of this study was to ass ess the need for radiographic staging of the injured patient for the diagno sis of ureteral injury before operative exploration. We conducted a retrosp ective review of all patients who sustained injury of the ureter as the res ult of external trauma over an 8 1/2-year period at an urban and suburban L evel I trauma center. All patients were injured through penetrating mechani sms and underwent laparotomy. Only three patients had preoperative radiogra phic staging of the urinary tract. No ureteral injuries were missed. We con clude that surgical exploration of the ureter is sufficiently accurate to o bviate the need for preoperative radiographic staging of the ureters in pat ients who have sustained penetrating injury and warrant laparotomy.