Ureteral injury due to penetrating trauma.

OBJECTIVES: We sought to evaluate the diagnosis and management of penetrating ureteral injuries at our trauma center.

METHODS: We retrospectively reviewed the cases of 12 patients with ureteral injuries secondary to penetrating ureteral trauma.

RESULTS: From January 1995 to December 2000, a total of 12 patients were diagnosed and treated for penetrating ureteral injuries. The diagnosis was made acutely in nine patients, and a delayed diagnosis was made in three patients. Hematuria was present in the nine patients diagnosed acutely, and these patients had either preoperative or intraoperative imaging. All patients underwent exploratory laparotomy, and ureteral injuries were missed in the three patients without radiologic imaging or hematuria. Repair of the ureteral injuries was highly successful, and patients diagnosed acutely had decreased morbidity.

CONCLUSIONS: Traumatic ureteral injuries from penetrating trauma are uncommon, and a high index of suspicion is necessary to diagnose ureteral injuries when hematuria is not present and imaging is nondiagnostic.