[Kidney trauma]

[Clinical experience in the diagnosis and treatment of kidney trauma]

BACKGROUND

Kidney trauma belongs to the rarely arising urological illnesses. In recent years guidelines for the treatment of urological injuries have been compiled by the Société Internationale d'Urologie (SIU) and the European Association of Urology (EAU). In the current literature increasingly more meaning is granted to a conservative in relation to a surgical therapy procedure, also with grade 4 and 5 kidney injuries.

PATIENTS

From 2002 to 2009, 83 patients with kidney injuries were treated in our hospital. There were 56 patients with grade 1 and grade 2 injuries, 12 patients with grade 3 and grade 4 injuries, and in addition, a total of 15 patients with a grade 5 injury.

RESULTS

In 75% of the cases a conservative procedure could be arranged depending on the further clinical course. In 25% of the cases, however, relative and/or absolute indications for operative intervention stood in the foreground, so that this group had an exploratory laparotomy. In 7 cases total nephrectomy had to be performed; however, in 11 cases organ-preserving surgery was possible.

[Clinical approach to renal trauma]

Management of kidney injuries is an uncommon challenge to urologists. Therapy has evolved in recent years from mainly surgical to predominantly conservative treatment. Immediate surgical intervention for renal trauma is now only necessary in rare instances. This overview is based on the guidelines of the European Association of Urology and the Societé International d'Urologie as well as clinical experience and is intended to provide practical advice for treatment of renal trauma.