Injuries of the urinary system ( kidney, bladder , urethra ) - Causes, Symptoms and Treatment .MF .
urinary organs injury - a damage of these organs caused by the action of mechanical force by the external environment.Depending on the affected organ are divided into renal injury, trauma, bladder and ureter injury.Damage to other organs are not considered due to their rare occurrence.
Causes of traumatic injuries organ
urinary system The most common cause of kidney injury is a blunt impact to the lumbar region.This occurs most often when a person falls on his back with a snowboard, skateboard or bike.In addition, such kidney damage is often diagnosed after the street fights.
cause of injury bladder , as a rule, is a blow to the suprapubic area.In most cases, the body rupture occurs only when the latter is full of urine.Applying the same blow to empty the bladder can threaten only submucosal hematoma, which resolves within a few weeks without any consequences.
quite specific trauma of genitourinary system is gap urethra.His cause, most often, is a drop in the bicycle frame or an open manhole
addition blunt or closed injuries of the genitourinary system, there are also open.Their cause can be chopped, cutting, torn or gunshot wound.In wartime trauma of the genitourinary system, in most cases, it was due to mine explosions.Most of these were penetrating injury of the bladder and urethra, where the fragments fell min.
Symptoms of traumatic injuries of the urinary system
main symptoms of blunt renal trauma is a pain in the lumbar region, violation of urination and blood in the urine.The pain usually is acute and localized to the side where the strike occurred.It increases with physical exertion and during urination.Some patients in the art hematoma determined different size and shape.Violation of urination for kidney injury may be accompanied by a decrease in the amount of urine and frequent urge reflex, which in some cases may even be imperative, ie without isolation of urine.Hematuria, or blood in the urine can vary from minor to whole sediment clots, which can be a sign of breakthrough bleeding.
hemorrhage retroperitoneal space
also often develops when trauma kidney renal hypertension, which has a malignant character and very poorly to medical treatment.
gap bladder accompanied hit urine into the abdominal cavity.In a short time this leads to diffuse peritonitis bladder, which, if left untreated, inevitably ends in death.In this situation, the patient concerned about acute abdominal pain, muscle tension anterior abdominal wall and the absence of urination.If the urine is released and, in very small quantities, mixed with blood and pus.
When traumatic injury of the bladder without breaking clinical symptoms poorer.The injury appears minor pain over the pubis and the same minor violation of urination.In some cases, patients may complain of the presence of a minor amount of blood in the urine sediment.
Even with little damage to the lumbar region and the pelvic area need immediate consultation of the urologist.The fact that the symptoms of traumatic injury can arise after some time after the injury.The urologist should determine the degree of severity to calculate the possibility of complications.
Diagnostics injuries bodies
urinary system at the initial stage of diagnosis of urinary organ damage carried plain radiography of the abdominal organs.It provides an opportunity to identify the presence of third-party items and traumatic agents in the abdominal cavity and retroperitoneal space.
More detailed data can be obtained after the excretory urography .Let her and points to structural changes in the renal parenchyma, but will provide an opportunity to judge the functional state of the body.Typically, when there is a violation of kidney injuries filter in one of the bodies, while at break ureter visible contrast going beyond the ureter.
Ultrasonography organs retroperitoneal spaces enables us to determine the morphological state of the kidneys.Most attention is paid in this case of the capsule, which may be ruptured or torn at all.To confirm the results of US assumptions can be used kidney angiography, which shows the character of the blood flow in the body.
to confirm bladder rupture applied voiding cystography , the essence of which is the introduction through the urethral catheter contrast medium and X-raying of the area of the body using X-ray machine.In the case of rupture of the bladder wall pouring marked contrast agent into the pelvic cavity.Also, in the absence of X-ray apparatus bladder rupture can be diagnosed using conventional staging "poking" the catheter into the peritoneal cavity, from which this pathology is allocated urine, blood stained.
gap bladder voiding cystogram
Among the modern methods of diagnosis of traumatic injuries of urinary organs should be allocated computed tomography with contrast .It provides more accurate results, as opposed to these ultrasound and excretory urography, which have a lot of shortcomings.
the presence of open injuries of the genitourinary system, when there is a wound channel, used a technique fistulography .It is to fill wound channel brilliant green or methylene blue for further revision of the latter.
Treatment of urinary tract injuries
Absolutely all patients with traumatic injuries of the urogenital system, regardless of their clinical condition, require compulsory hospitalization in profile department .It carried them carefully monitored in order to detect complications and purpose of correct tactics of treatment, which may be conservative or operative.
Traumatic rupture treated kidney surgery, in which the body sutured defect or removes the last.The operation usually ends nephrostomy urine evacuation that constantly seeps in the area of post-operative wounds.During the operation, it is sure to provide a thorough audit of soft tissue for the presence of third-party items, if it was an open kidney injury.
treatment of bladder rupture is to carry out an operation for the repair of the defect of its wall.Superimposed conventional double-row suture, which seals the cavity of the bladder.Postoperatively very important good evacuation of urine from the bladder in order not to increase the pressure inside the body, which can contribute to discrepancies seams imposed on its wall.
In principle, the operative treatment of fractures ureter and urethra is no different.It also produced the subsequent closure of the defect with adequate drainage.
Conservative treatment of injuries of the urogenital tract is the appointment of antibacterial and analgesic therapy.The first can be used as drugs such as ceftriaxone, gatifloxacin and ofloxacin, as well as the second - Analgin, Diclofenac or Ketanov.conservative course of treatment depends on the severity of traumatic injury and the patient's subjective sensations.
treatment of injuries of the urogenital tract folk remedies
Application compresses on the area of traumatic injury in minor injuries can produce positive results.They relieve pain and accelerate resorption of the hematoma in the presence of the latter.The use of these methods when rupture or bleeding is not only useless, but also dangerous, because the fact postpones the application of qualified medical assistance.Therefore, apply compresses and any other traditional methods of treatment is possible only after consultation of the urologist.
Feeding habits and lifestyle
Limit foods in patients with injuries of organs of the excretory system can only in the event of their surgery.This diet is assigned the number 0, which means starvation before surgery.This is done with the expectation that during anesthesia in patients is often marked by vomiting reflex, which makes it difficult to process the operation.
trauma patients is recommended to perform physical therapy treatments in the postoperative period.Doctors believe that the holding of UHF darsonvalization and accelerates the process of healing and recovery.
also mandatory, as in all other diseases assigned treatment preparations containing beneficial bacteria.This is done on the basis of the fact that the patients after a prolonged course of antibiotic therapy interferes with the normal intestinal microflora.
injury Complications of urinary organs
Two of the most dangerous complications of these injuries - it is bleeding and peritonitis.The first lesion can develop at any of these authorities, in the event of rupture of a large vessel.In this case, the blood is released into the lumen of the bladder or the retroperitoneal space.
peritonitis develops in the perforation of the bladder wall.Urine rapidly fills all spaces and floors of the abdominal cavity, which leads to development of severe inflammation, which can even be lethal.
injury prevention agencies
urinary system the most dangerous professions in terms of injuries organs of the excretory system are considered racers and builders.Therefore, it is recommended during adhere to safety regulations and use personal protective equipment.
addition, renal trauma frequently occur in automobile accidents.Thus, the installation of the airbag can also be considered as a type of prevention of injuries of the urinary system.
Ed.urologist Astashin EE