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Pediatric Urologic Trauma

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Practical Pediatric Urology

Abstract

Genitourinary trauma is second most common cause of trauma in pediatric patient with an estimated rate of 3–10%;with renal trauma contributing to 50% of GU injuries. Most injuries are result of motor vehicle accidents and it can precipitate unique urological problems and morbidity associated with the injury. The following is a review of pertinent clinical information and surgical managements regarding pediatric urologic trauma with supporting evidence from the current literature and guidelines.

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References

  1. Grimsby GM, Voelzke B, Hotaling J, Sorensen MD, Koyle M, Jacobs MA. Demographics of pediatric renal trauma. J Urol. 2014;192(5):1498–502.

    Article  PubMed  Google Scholar 

  2. Murphy GP, Gaither TW, Awad MA, et al. Management of Pediatric Grade IV renal trauma. Curr Urol Rep. 2017;18(3):23.

    Article  PubMed  Google Scholar 

  3. Brown SL, Elder JS, Spirnak JP. Are pediatric patients more susceptible to major renal injury from blunt trauma? A comparative study. J Urol. 1998;160(1):138–40.

    Article  CAS  PubMed  Google Scholar 

  4. Dangle PP, Fuller TW, Gaines B, et al. Evolving mechanisms of injury and Management of Pediatric Blunt Renal Trauma--20 years of experience. Urology. 2016;90:159–63.

    Article  PubMed  Google Scholar 

  5. Jacobs MA, Hotaling JM, Mueller BA, Koyle M, Rivara F, Voelzke BB. Conservative management vs early surgery for high grade pediatric renal trauma--do nephrectomy rates differ? J Urol. 2012;187(5):1817–22.

    Article  PubMed  PubMed Central  Google Scholar 

  6. Morey AF, Brandes S, Dugi DD 3rd, et al. Urotrauma: AUA guideline. J Urol. 2014;192(2):327–35.

    Article  PubMed  PubMed Central  Google Scholar 

  7. Serafetinides E, Kitrey ND, Djakovic N, et al. Review of the current management of upper urinary tract injuries by the EAU trauma guidelines panel. Eur Urol. 2015;67(5):930–6.

    Article  PubMed  Google Scholar 

  8. Cannon GM Jr, Polsky EG, Smaldone MC, et al. Computerized tomography findings in pediatric renal trauma--indications for early intervention? J Urol. 2008;179(4):1529–32; discussion 1532–1523.

    Article  PubMed  Google Scholar 

  9. Gerstenbluth RE, Spirnak JP, Elder JS. Sports participation and high grade renal injuries in children. J Urol. 2002;168(6):2575–8.

    Article  PubMed  Google Scholar 

  10. Hussman DA. Chapter 154: pediatric genitourinary trauma. In: Wein AJ, Kavoussi LR, Partin AW, Peters CA, editors. Campbell Walsh urology. 11th ed. Philadelphia, PA: Elsevier-Saunders. p. 3538.

    Google Scholar 

  11. Committee on Sports Medicine and Fitness. Medical conditions affected sports participation. Pediatrics. 2001;107:1205–9.

    Article  Google Scholar 

  12. Pumberger W, Stoll E, Metz S. Ureteropelvic junction disruption following blunt abdominal trauma. Pediatr Emerg Care. 2002;18(5):364–6.

    Article  PubMed  Google Scholar 

  13. Kawashima A, Sandler CM, Corriere JN Jr, Rodgers BM, Goldman SM. Ureteropelvic junction injuries secondary to blunt abdominal trauma. Radiology. 1997;205(2):487–92.

    Article  CAS  PubMed  Google Scholar 

  14. Al-Qudah HS, Santucci RA. Complications of renal trauma. Urol Clin North Am. 2006;33(1):41–53, vi.

    Article  PubMed  Google Scholar 

  15. Kunkle DA, Kansas BT, Pathak A, Goldberg AJ, Mydlo JH. Delayed diagnosis of traumatic ureteral injuries. J Urol. 2006;176(6 Pt 1):2503–7.

    Article  PubMed  Google Scholar 

  16. Pereira BM, Ogilvie MP, Gomez-Rodriguez JC, et al. A review of ureteral injuries after external trauma. Scand J Trauma Resusc Emerg Med. 2010;18:6.

    Article  PubMed  PubMed Central  Google Scholar 

  17. Guttmann I, Kerr HA. Blunt bladder injury. Clin Sports Med. 2013;32(2):239–46.

    Article  PubMed  Google Scholar 

  18. Carroll PR, McAninch JW. Major bladder trauma: mechanisms of injury and a unified method of diagnosis and repair. J Urol. 1984;132(2):254–7.

    Article  CAS  PubMed  Google Scholar 

  19. Zacharias C, Robinson JD, Linnau KF, Mannelli L. Blunt urinary bladder trauma. Curr Probl Diagn Radiol. 2012;41(4):140–1.

    Article  PubMed  Google Scholar 

  20. Bryk DJ, Zhao LC. Guideline of guidelines: a review of urological trauma guidelines. BJU Int. 2016;117(2):226–34.

    Article  PubMed  Google Scholar 

  21. Kotkin L, Koch MO. Morbidity associated with nonoperative management of extraperitoneal bladder injuries. J Trauma. 1995;38(6):895–8.

    Article  CAS  PubMed  Google Scholar 

  22. Summerton DJ, Djakovic N, Kitrey ND, et al. European association of urology. Guidelines on urological trauma. March 2015.

    Google Scholar 

  23. Kim S, Linden B, Cendron M, Puder M. Pediatric anorectal impalement with bladder rupture: case report and review of the literature. J Pediatr Surg. 2006;41(9):E1–3.

    Article  PubMed  Google Scholar 

  24. Routh JC, Graham DA, Nelson CP. Epidemiological trends in pediatric urolithiasis at United States freestanding pediatric hospitals. J Urol. 2010;184(3):1100–4.

    Article  PubMed  Google Scholar 

  25. Routh JC, Husmann DA. Long-term continence outcomes after immediate repair of pediatric bladder neck lacerations extending into the urethra. J Urol. 2007;178(4 Pt 2):1816–8; discussion 1818.

    Article  PubMed  Google Scholar 

  26. Deibert CM, Glassberg KI, Spencer BA. Repair of pediatric bladder rupture improves survival: results from the National Trauma Data Bank. J Pediatr Surg. 2012;47(9):1677–81.

    Article  PubMed  Google Scholar 

  27. Voelzke BB, Breyer BN, McAninch JW. Blunt pediatric anterior and posterior urethral trauma: 32-year experience and outcomes. J Pediatr Urol. 2012;8(3):258–63.

    Article  PubMed  Google Scholar 

  28. Holland AJ, Cohen RC, McKertich KM, Cass DT. Urethral trauma in children. Pediatr Surg Int. 2001;17(1):58–61.

    Article  CAS  PubMed  Google Scholar 

  29. Podesta M, Podesta M Jr. Delayed surgical repair of posttraumatic posterior urethral distraction defects in children and adolescents: long-term results. J Pediatr Urol. 2015;11(2):67.e61–66.

    Article  Google Scholar 

  30. Lehnert BE, Sadro C, Monroe E, Moshiri M. Lower male genitourinary trauma: a pictorial review. Emerg Radiol. 2014;21(1):67–74.

    Article  PubMed  Google Scholar 

  31. Goldman SM, Sandler CM, Corriere JN Jr, McGuire EJ. Blunt urethral trauma: a unified, anatomical mechanical classification. J Urol. 1997;157(1):85–9.

    Article  CAS  PubMed  Google Scholar 

  32. Dixon AN, Webb JC, Wenzel JL, Wolf JS Jr, Osterberg EC. Current management of pelvic fracture urethral injuries: to realign or not? Translational andrology and urology. 2018;7(4):593–602.

    Article  PubMed  PubMed Central  Google Scholar 

  33. Koraitim MM. Posttraumatic posterior urethral strictures in children: a 20-year experience. J Urol. 1997;157(2):641–5.

    Article  CAS  PubMed  Google Scholar 

  34. Barrett K, Braga LH, Farrokhyar F, Davies TO. Primary realignment vs suprapubic cystostomy for the management of pelvic fracture-associated urethral injuries: a systematic review and meta-analysis. Urology. 2014;83(4):924–9.

    Article  PubMed  Google Scholar 

  35. Onen A, Ozturk H, Kaya M, Otcu S. Long-term outcome of posterior urethral rupture in boys: a comparison of different surgical modalities. Urology. 2005;65(6):1202–7.

    Article  PubMed  Google Scholar 

  36. Nerli RB, Koura AC, Ravish IR, Amarkhed SS, Prabha V, Alur SB. Posterior urethral injury in male children: long-term follow up. J Pediatr Urol. 2008;4(2):154–9.

    Article  CAS  PubMed  Google Scholar 

  37. Meltzer JA, Reddy SH, Blumfield E, Alvayay C, Blumberg SM. Pelvic fracture urethral injuries in children: a case report and appraisal of their emergency management. Pediatr Emerg Care. 2016;32(9):627–9.

    Article  PubMed  Google Scholar 

  38. Pippi Salle JL, Jesus LE, Lorenzo AJ, et al. Glans amputation during routine neonatal circumcision: mechanism of injury and strategy for prevention. J Pediatr Urol. 2013;9(6 Pt A):763–8.

    Article  PubMed  Google Scholar 

  39. Baskin LS, Canning DA, Snyder HM 3rd, Duckett JW Jr. Surgical repair of urethral circumcision injuries. J Urol. 1997;158(6):2269–71.

    Article  CAS  PubMed  Google Scholar 

  40. Weiss HA, Larke N, Halperin D, Schenker I. Complications of circumcision in male neonates, infants and children: a systematic review. BMC Urol. 2010;10:2.

    Article  PubMed  PubMed Central  Google Scholar 

  41. Mousavi SA, Salehifar E. Circumcision complications associated with the Plastibell device and conventional dissection surgery: a trial of 586 infants of ages up to 12 months. Adv Urol. 2008;606123.

    Google Scholar 

  42. Ozen MA, Gundogdu G, Tasdemir M, Eroglu E. Complication of newborn circumcision: Meatal stenosis or meatal web? J Pediatr Urol. 2017;13(6):617.e611–4.

    Article  Google Scholar 

  43. Yang C Jr, Song B, Liu X, Wei GH, Lin T, He DW. Acute scrotum in children: an 18-year retrospective study. Pediatr Emerg Care. 2011;27(4):270–4.

    Article  PubMed  Google Scholar 

  44. Wang Z, Yang JR, Huang YM, et al. Diagnosis and management of testicular rupture after blunt scrotal trauma: a literature review. Int Urol Nephrol. 2016;48(12):1967–76.

    Article  PubMed  Google Scholar 

  45. Dalton DM, Davis NF, O’Neill DC, Brady CM, Kiely EA, O’Brien MF. Aetiology, epidemiology and management strategies for blunt scrotal trauma. The surgeon : journal of the Royal Colleges of Surgeons of Edinburgh and Ireland. 2016;14(1):18–21.

    Article  CAS  PubMed  Google Scholar 

  46. Fenton LZ, Karakas SP, Baskin L, Campbell JB. Sonography of pediatric blunt scrotal trauma: what the pediatric urologist wants to know. Pediatr Radiol. 2016;46(7):1049–58.

    Article  PubMed  Google Scholar 

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Correspondence to Pankaj P. Dangle .

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Boyd, C., Gibson, E., Dangle, P.P. (2021). Pediatric Urologic Trauma. In: Godbole, P., Wilcox, D.T., Koyle, M.A. (eds) Practical Pediatric Urology. Springer, Cham. https://doi.org/10.1007/978-3-030-54020-3_20

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  • DOI: https://doi.org/10.1007/978-3-030-54020-3_20

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  • Online ISBN: 978-3-030-54020-3

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