ABSTRACT
Introduction: The kidneys are the most common genitourinary organs injured from external trauma, whereas ureteric trauma is rare, accounting for less than 1% all urological trauma. ureteric injury from blunt trauma is extremely rare. Advances in radiographic staging, improvements in hemodynamic monitoring, validated renal and ureteric injury scoring systems, and essential details about the mechanisms of injury allow successful conservative management strategies for renal preservation. The main purpose of this study was to suggest that conservative management will suffice in high grade renal injury also, if the patient is hemodynamically stable, and it will increase the chance renal conservation, avoiding unnecessary nephrectomies. Aims and objectives: The main aim of this study was to evaluate and stage blunt upper urinary tract injury and also assess management outcomes in such patients. Materials and methods: All the patients with blunt upper urinary tract injury diagnosed radiologically from February 2017 to January 2019 were admitted and the injuries were graded by using American association for the surgery of trauma grading. Stable patients had conservative management and operative management for unstable patients. All the patients followed up for a min of 3-18 months with a median of 6 months. Results: In our study, out of total 43 cases, 3 (6.9%) cases required emergency intervention in view of hemodynamic instability. In these 3 cases 2 underwent total nephrectomy (both are grade V injuries) and one case required renorrhaphy (grade IV injury). In remaining 40 cases kept on conservative Ravi Jahagirdar, Ravi Chander, K. Kishore, K. Gopikanth, Rajesh Singh, Vinay Jahagirdar. Our experience with traumatic injuries of the upper urinary tract. IAIM, 2019; 6(11): 99-110. Page 100 management 2 cases required delayed intervention. One case required nephrectomy and the other one required partial nephrectomy. Conclusion: In Renal trauma of all the grades conservative management is a good option in hemodynamically stable patients whereas unstable patients need laparotomy. Conservative management enables us to save as much renal function as possible which should be our aim.