Urologic injuries

The various important phases of injury of the urogenital apparatus have been briefly discussed with items of medicolegal interest kept in the foreground. From the legal aspect the importance of obtaining an accurate history of the nature of the injury and the circumstances leading up to it are particularly important. Frequently the condition of patients urologically injured is so grave that good surgical judgment permits only a casual physical examination rather than a complete urologic investigation. Excretory urography gives the most valuable roentgenographic information concerning injuries of the kidney, ureter and bladder. The advantages of conservative surgical treatment in a large proportion of urologic injuries should be kept in mind. Yet the surgeon must be alert to the indications for prompt and radical intervention. Operative speed is imperative. The patient should not be allowed to die of shock or hemorrhage either while we attempt to establish an accurate minute anatomic diagnosis preoperatively or by attempting at operation to observe all of the niceties of surgical technique. In other words the surgeon should get in and get out and in general be content to stop hemorrhage, sketchily repair important structures, and above all establish free drainage.