General principles of urological trauma

Key points

• The priority is patient stabilization (ABCDE), not urological investigation.
• The absence of hematuria does not exclude urological trauma.
• Contrast-enhanced CT is the modality of choice in a stable patient.
• In instability, control bleeding immediately.

Danger signs

• Hemodynamic instability.
• Gross hematuria.
• Pelvic fractures.
• Flank or lower back pain.
• Loss of consciousness.

Diagnosis

• Contrast-enhanced CT in stable patients.
• Ultrasonography (FAST) in instability.
• Laboratory tests: Hb, creatinine, blood group, coagulation profile.

Emergency management

• Stabilization → imaging → classification → observation or intervention.
• Organ preservation is the priority when safe.

Algorithm