Single shot intraoperative excretory urography for the immediate evaluation of renal trauma.

Department of Urology, University of California, School of Medicine, San Francisco General Hospital, 94110, USA.
The Journal of Urology (Impact Factor: 3.75). 05/1999; 161(4):1088-92. DOI: 10.1097/00005392-199904000-00009
Source: PubMed

ABSTRACT We reviewed the quality and usefulness of single shot intraoperative excretory urography (IVP) for evaluating suspected upper urinary tract trauma at our trauma center.
Between 1990 and 1997 single shot intraoperative IVP for staging renal injuries was performed in 50 patients in whom clinical instability and/or major associated injuries mandated an intraoperative study. Contrast material (2 ml/kg) was injected intravenously and images were obtained after 10 minutes. The quality and usefulness of each study were scored by a single attending urologist on a scale of 1-worst to 5-best.
Intraoperative study quality was generally good (average score 3.84). The information obtained was generally considered useful for determining urological treatment (average score 3.96). In 16 patients (32%) intraoperative IVP findings safely obviated renal exploration. No contrast medium reactions were noted and no complications developed that were attributable to intraoperative IVP.
Intraoperative single shot, high dose IVP is safe, efficient and of high quality in the majority of cases when performed as recommended. This study often provides important information that facilitates rapid and accurate decision-making. Intraoperative IVP is a useful tool for guiding the exploration of penetrating renal injuries and confirming blunt renal injuries that may be safely observed.

1 Follower
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Both iatrogenic and traumatic ureteral injuries are rare. However, a high index of suspicion is warranted for ureteral injuries because ureteral injuries are associated with increased morbidity. The urologist should be familiar with several methods for identifying ureteral injuries and should make evaluations tailored to the clinical situation. Most ureteral injuries are short transections and can be repaired with debridement and ureteroureterostomy in the proximal and mid-ureter or ureteroneocystostomy in the distal ureter.
    Urologic Clinics of North America 03/2006; 33(1):55-66, vi. DOI:10.1016/j.ucl.2005.11.005 · 1.35 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Optimal management of penetrating abdominal trauma, especially for kidney and splenic injuries, is evolving. Opinions range from aggressive surgical exploration to expectant management. This report addresses the recent advancements in the diagnosis, grading, and management of penetrating injuries to the kidney and spleen. A special focus is provided on the shifting paradigm towards non-operative management. Penetrating renal trauma management has evolved significantly over the past few years. Advancements in diagnostic tools and evolution of injury grading have paved the way for selective non-operative management. Penetrating injuries to the spleen provide a unique management challenge. With the evolution of non-operative management, appropriate patient selection is mandatory. Optimal use of computed tomography scanning and angiography can improve the organ salvage rates; however, hemorrhage control is still the main goal.
    04/2015; 1(1):1-9. DOI:10.1007/s40719-015-0016-9
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: PurposeThe purpose of this study is to describe the clinical characteristics of patients diagnosed with renal trauma at Hospital Universitario Del Valle (HUV) in Cali, Colombia.
    Actas urologicas españolas 09/2009; 33(8):881-887. DOI:10.1016/S0210-4806(09)72876-1 · 1.15 Impact Factor