| 3. Morey AF, Broghammer JA, Hollowell CMP, McKibben MJ, Souter L. Urotrauma Guideline 2020: AUA Guideline. J Urol. 2021 Jan;205(1):30-35. |
Review/Other-Dx |
N/A |
To guide clinicians in the appropriate methods of evaluation and management of genitourinary injuries. |
The Panel updated a total of six existing statements on renal, ureteral, bladder, urethra, and genital trauma. Additionally, four new statements were added based on literature released since the 2017 amendment. Statement 5b was added based on new evidence for treatment of hemodynamically unstable patients with renal trauma. Statement 20b was added based on new literature for percutaneous or open suprapubic tube placement following pelvic fracture urethral injury. Statements 30a and 30b were also added to provide guidance on ultrasonography for blunt scrotal injuries suggestive of testicular rupture and for performing surgical exploration with repair or orchiectomy for penetrating scrotal injuries respectively. |
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| 4. Dane B, Baxter AB, Bernstein MP. Imaging Genitourinary Trauma. Radiol Clin North Am. 2017 Mar;55(2):S0033-8389(16)30154-3. |
Review/Other-Dx |
N/A |
To review radiologic imaging in genitourinary trauma |
MDCT can quickly and accurately assess trauma patients for renal, ureteral, and bladder injuries. Moreover, CT guides clinical management triaging patients to those requiring discharge, observation, angioembolization, and surgery. Recognition of urinary tract trauma on initial scan acquisition should prompt delayed excretory phase imaging to identify urine leaks. Urethral and testicular trauma are imaged with retrograde urethrography and sonography, respectively. |
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| 9. Ingram MD, Watson SG, Skippage PL, Patel U. Urethral injuries after pelvic trauma: evaluation with urethrography. [Review] [14 refs]. Radiographics. 28(6):1631-43, 2008 Oct. |
Review/Other-Dx |
N/A |
To review role of urethrography in the evaluation of urethral injuries. |
Although CT is usually used for the initial imaging evaluation of patients with polytrauma, urethral injury is better assessed and classified by using urethrography. |
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| 11. Coccolini F, Moore EE, Kluger Y, et al. Kidney and uro-trauma: WSES-AAST guidelines. World J Emerg Surg. 2019;14():54. |
Review/Other-Dx |
N/A |
To present the World Society of Emergency Surgery (WSES) and the American Association for the Surgery of Trauma (AAST) kidney and urogenital trauma management guidelines. |
No results stated in abstract. |
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| 12. Schneider RE.. Genitourinary trauma. Emerg Med Clin North Am. 11(1):137-45, 1993 Feb. |
Review/Other-Dx |
N/A |
Examine genitourinary trauma and patients at risk for urology injury, review physical findings and describe present radiographic procedures that allow for proper diagnosis and treatment. |
A retrograde urethrogram is the diagnostic procedure of choice in all cases of suspected urethral injury. Recommends retrograde cystography or retrograde CT cystography for suspected bladder injury. |
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| 13. Bock SA, Sampson HA, Atkins FM, et al. Double-blind, placebo-controlled food challenge (DBPCFC) as an office procedure: a manual. J Allergy Clin Immunol. 1988 Dec;82(6):986-97. |
Review/Other-Dx |
N/A |
To discusses the practical methods required for the allergist to undertake DBPCFC in the office. |
No results stated in abstract. |
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| 14. Corriere JN, Jr., Sandler CM. Diagnosis and management of bladder injuries. Urol Clin North Am. 2006; 33(1):67-71, vi. |
Review/Other-Dx |
N/A |
Review diagnosis and treatment of injuries to the bladder. |
Diagnosis is made by a retrograde static cystogram performed by filling the bladder with contrast through a urethral catheter. |
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| 15. Jankowski JT, Spirnak JP. Current recommendations for imaging in the management of urologic traumas. Urol Clin North Am. 2006 Aug;33(3):365-76. |
Review/Other-Dx |
N/A |
Review current recommendations for imaging in urologic traumas. |
Choice of modality is based on mechanism of injury and patient presentation. For pelvic injuries and gross hematuria, CT cystography or conventional cystography is recommended. For scrotal trauma when physical exam is inconclusive, US is recommended. For patients with penetrating trauma to the external genitalia, retrograde urethrography is recommended. |
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| 16. Sandler CM, Hall JT, Rodriguez MB, Corriere JN. Bladder injury in blunt pelvic trauma. Radiology. 1986 Mar;158(3):633-8. |
Observational-Dx |
97 patients |
Review clinical and radiologic findings in patients with bladder injury secondary to blunt pelvic trauma. |
All cases (n=55) of extraperitoneal rupture were demonstrated cryptographically.In 15 cases in this group, the injury was complex, with extravasation of contrast material beyond the confines of the perivesical space. In two additional patients, incomplete bladder injury termed "interstitial bladder rupture" was identified. Study proposes a classification of bladder injury based on cystographic patterns of extravasations. |
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| 17. Sandler CM, Goldman SM, Kawashima A. Lower urinary tract trauma. World J Urol. 1998;16(1):69-75. |
Review/Other-Dx |
N/A |
Review and illustrate bladder and urethral injuries, including their mechanisms of injury, imaging diagnosis, systems for classification, and the accuracy/pitfalls of the diagnostic methods. Emphasis is on lower urinary tract injuries. |
Lower urinary tract injuries resulting from high speed, wide impact blunt trauma is the most common mechanism of lower urinary tract injury encountered in civilian practice. |
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| 18. Horstman WG, McClennan BL, Heiken JP. Comparison of computed tomography and conventional cystography for detection of traumatic bladder rupture. Urol Radiol. 1991;12(4):188-93. |
Observational-Dx |
25 patients |
To compare conventional cystograms and CT examinations for detection of traumatic bladder rupture. |
5 of 25 had bladder ruptures. All 5 were detected by both CT and conventional cystogram. If properly performed, CT is as sensitive for detection of bladder injuries as conventional cystography. |
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| 19. Yeung LL, McDonald AA, Como JJ, et al. Management of blunt force bladder injuries: A practice management guideline from the Eastern Association for the Surgery of Trauma. J Trauma Acute Care Surg. 2019 Feb;86(2):326-336. |
Review/Other-Dx |
N/A |
To formulate a practice management guideline using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) methodology. |
Three hundred ninety-three articles were screened, resulting in a full-text review of 64 articles. Seventeen articles were used to formulate the recommendations of this guideline. Several recommendations are made. The need for initial computed tomography cystography after trauma depends on characteristics of the trauma itself, but it is not recommended in patients without gross hematuria. In general, patients with intraperitoneal bladder ruptures should undergo operative repair. This is not routinely necessary in those with extraperitoneal ruptures unless the injury is complex. The need for follow-up cystography after bladder repair depends on the risk of urine leak. Those with low risk of urine leak do not require a follow-up study. |
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| 20. Carroll PR, McAninch JW. Major bladder trauma: the accuracy of cystography. J Urol. 1983 Nov;130(5):887-8. |
Observational-Dx |
51 patients |
To study accuracy of retrograde cystography in diagnosing traumatic bladder rupture. |
Extravasation was observed in 32 cases for which retrograde cystograms were available, including 3 (9%) in which additional infusion of contrast medium was required to demonstrate extravasation. Of the 32 cystograms 4 (13%) showed rupture on the drainage film only. If drainage radiographs and adequate distension of the bladder with contrast medium had been omitted, the rate of diagnostic accuracy of the cystogram would have been reduced to 79%. If attention is paid to adequate distension of the bladder with contrast material and to obtaining drainage films, diagnostic retrograde cystography for trauma should be almost totally accurate and delays or errors in diagnosis should be rare. |
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| 21. Chou CP, Huang JS, Wu MT, et al. CT voiding urethrography and virtual urethroscopy: preliminary study with 16-MDCT. AJR Am J Roentgenol. 2005 Jun;184(6):1882-8. |
Review/Other-Dx |
13 men |
CT voiding urethrography exams were prospectively performed with 16-MDCT to demonstrate CT voiding urethrography and CT virtual urethroscopy. |
The full urethral structure was clearly shown by CT voiding urethrography and virtual urethroscopy in all patients. The results of CT voiding urethrography and conventional methods correlated closely with the urethral diseases being imaged. |
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| 22. Hsieh CH, Chen RJ, Fang JF, et al. Diagnosis and management of bladder injury by trauma surgeons. Am J Surg. 2002 Aug;184(2):143-7. |
Observational-Dx |
51 patients |
Retrospective review to analyze how bladder injuries have been managed as part of multiple traumas. |
33 patients had abdominal CT, but only 20 were correctly diagnosed with accuracy of 60.6%. 24 patients had retrograde cystogram, with accuracy of 95.9% (23 of 24). Retrograde cystogram was performed in fewer than half of the patients (24 of 51), which means it is not feasible in many situations. |
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| 23. Chan DP, Abujudeh HH, Cushing GL, Novelline RA. CT cystography with multiplanar reformation for suspected bladder rupture: experience in 234 cases. AJR Am J Roentgenol. 2006 Nov;187(5):1296-302. |
Observational-Dx |
234 patients |
Retrospective review was performed to determine the accuracy of CT cystography and the role of multiplanar reformation in the diagnosis of bladder injury. |
From the total of 234 examinations, 216 (92.3%) were interpreted as negative and 18 examinations (7.7%) were interpreted as positive. On the 18 positive examinations, 11 were extraperitoneal bladder rupture, five were intraperitoneal bladder rupture, and two were combined intraperitoneal and extraperitoneal bladder rupture. Surgical bladder exploration and repair were performed in nine of the 18 cases. Seven (77.8%) of the nine cases had operative findings consistent with the CT cystogram findings. The overall sensitivity and specificity of CT cystography in diagnosing bladder rupture were each 100%. For extraperitoneal bladder rupture, the sensitivity and specificity were 92.8% and 100%, respectively. For intraperitoneal rupture, the sensitivity and specificity were 100% and 99%, respectively. CT cystography is accurate for diagnosing bladder rupture. Sagittal and coronal multiplanar reformations may be helpful in identifying most sites of bladder rupture. |
3 |
| 24. Bigongiari LR, Zarnow H. Traumatic, Inflammatory, Neoplastic, and Miscellaneous Lesions of the Bladder. In: Lang EK, ed. Radiology of the Lower Urinary Tract. Berlin, Heidelberg: Springer Berlin Heidelberg; 1994:69-147. |
Review/Other-Dx |
N/A |
Book chapter. |
No abstract available. |
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| 25. Kim B, Kawashima A, LeRoy AJ. Imaging of the male urethra. Semin Ultrasound CT MR. 2007 Aug;28(4):258-73. |
Review/Other-Dx |
N/A |
To describe imaging techniques, anatomy, and findings of various urethral and periurethral pathology in the male. |
Cross-sectional imaging techniques of US, CT and MRI have been increasingly used for urethral and periurethral abnormalities in recent times. These studies are useful as an adjunctive tool in patients with the complex anatomical derangements. |
4 |
| 26. Koraitim MM, Reda IS. Role of magnetic resonance imaging in assessment of posterior urethral distraction defects. Urology. 2007 Sep;70(3):403-6. |
Observational-Dx |
21 men |
To determine value of MRI in the assessment of posterior urethral distraction defects. Compared MRI and urethrographic findings and correlated with operative findings. MRI findings were also correlated with the incidence of posttraumatic impotence. |
On MRI, the length of urethral defect and type of prostatic displacement could be correctly determined in 86% and 89% of the patients, respectively. MRI precisely delineated the extent of scar tissue and revealed the presence of paraurethral false tracks in 3 patients. MRI also showed avulsion of the corpus cavernosum, as well as lateral prostatic displacement in all 6 patients with posttraumatic impotence. |
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