Ureteral injury due to external violence: 49 cases over 5 years

A total of 49 cases of ureteral trauma secondary to external violence occurring over 5 years were reviewed with regard to etiology, diagnosis, associated injury, management, and follow-up. In all, 47 cases (95.9%) of penetrating and 2 (4.1%) of blunt trauma occurred; 45 cases (91.8%) occurred in men and 4 (8.2%), in women. Both blunt ureteral injuries were secondary to auto/pedestrian accidents. Overall, 92% of ureteral injuries were associated with injury to other organ systems. Our management principles for ureteral injuries have previously been reported [2, 3]. These include debridement, a watertight, tension-free anastomosis, isolation of the anastomosis, and Penrose drainage of the area proximal to the anastomosis. Postoperative complications occurred in eight patients; these consisted of three strictures, two urinomas, two cutaneous fistulas, and one perinephric abscess. There were six perioperative deaths, all unrelated to the genitourinary injuries.