Index. F Female pelvis anatomy, 283 Female urethra anatomy, 252, 253 Fistula formation after bladder trauma, 69

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1 A Abdominal hysterectomy, 66 Abscess bladder trauma, 69 epididymo-orchitis, 128, 130 prostatic clinical presentation, 124 radiologic evaluation, 124, 125 renal, 111 treatment, 124, 126 Acquired renal artery infarction surgical procedures, trauma, 156 Acute bacterial prostatitis definition and presentation, 123 laboratory examination, pathogens, 124 physical examination, 123 related urologic problems, 124 treatment, 124 Acute bacterial urethritis. See Urethritis, acute bacterial Acute scrotum clinical presentation acute hydrocele, 210 differential diagnosis, 210 testicular torsion, epididymitis/epididymo-orchitis clinical presentation, treatment, 213 miscellaneous causes, scrotal and perineal burns, 214 testicular and appendiceal torsion appendix testis and epididymis, 207, 209 bell clapper deformity, 207, 208 tunica vaginalis, 207, 208 testicular trauma clinical presentation, treatment, 214 treatment, Acute urinary retention (AUR) anatomy and neuroanatomy female urethra, 252, 253 male urethra, 252 bladder outlet obstruction BPH, 253 causes of female, 253, 254 causes of male, 253, 254 clinical findings history, imaging, 256 physical examination and laboratory evaluation, 256 techniques, for urinary drainage, 258 treatment, urethral catheterization, 257 epidemiology, 251 etiology, 252 impaired detrusor contractility, long-term management, 259 management long-term, 259 post-drainage, suprapubic cystostomy, 258 urethra, 258 Adrenal hemorrhage neoplastic, 164, systemic, 164, Adrenergic agents, priapism treatment, 200 Alpha-adrenergic antagonists (a-blockers), Alum, 188 Ambiguous genitalia. See Disorders of sex development (DSD) American Association for the Surgery of Trauma (AAST) staging system for bladder trauma, 62 staging system for genitalia trauma, 85 staging system for kidney injury, 21 23, staging system for ureteral injury, 44, 45 American Urological Association guidelines on priapism treatment Al-Ghorab shunt, 200, 202 cardiovascular effects, 200 clinical and blood gas fi ndings, 198, 199 duplex doppler ultrasonography, 202, 203 management algorithm, 198, 199 percutaneous shunts, 200, 201 proximal shunts, 200, 203 Anterior bladder wall flap tubularized, ureteral reconstruction, 290 Anterior urethra trauma blunt trauma, 73 H. Wessells (ed.), Urological Emergencies: A Practical Approach, Current Clinical Urology, DOI / , Springer Science+Business Media New York 2005,

2 334 delayed reconstruction, diagnosis, initial management, penetrating trauma, 73 Anticholinergics, 232 Anti-inflammatory drugs, Appendix testis, 207, 209 Arteriovenous malformation/fistula (AVM/AVF) clinical management, clinical presentation, 170 diagnosis, 172 etiology, secondary hemorrhage, 33 treatment, 175 AUA-EAU guidelines on medical expulsive therapy for ureteral calculi, 232 Augmentation enterocystoplasty rupture, complications, 328 AUR. See Acute urinary retention (AUR) Avulsion injuries penile clinical management, pathophysiology, 93 scrotum, B Bell clapper deformity, 207 Benign prostate hyperplasia (BPH), 253 Bites, external genitalia injury clinical management, 97 pathophysiology, 89 Bladder contusion, 59 Bladder exstrophy delayed primary closure, 302 incidence, 298 primary exstrophy closure, reconstruction, 302 Bladder outlet obstruction BPH, 253 causes of female, 253, 254 of male, 253, 254 Bladder perforation, 328 Bladder stones, Bladder trauma abdominal hysterectomy, 66 anatomy, 55 associated injuries, 58 augmentation enterocystoplasty, classification, clinical management abdominal exploration, 65 bladder drainage, 64 evaluation and treatment methods, 63 Foley catheter/suprapubic tube, 64 healing impairment, 64 intraperitoneal bladder ruptures, 65 penetrating injuries, 62 complications abscess formation, 69 fistula formation, 69 incontinence, conventional cystography, 59, CT cystography, focused assessment with sonography for trauma (FAST), 61 iatrogenic injuries, indications for imaging, 58 intraperitoneal rupture, 57 laparoscopy, mechanism, 56 neobladder rupture, 68 prevalence, 9 signs and symptoms, 56, 58 vaginal surgery, 66 Blunt injuries, epidemiology, Blunt penile trauma clinical management, pathophysiology, Blunt renal trauma, 21, 22 Blunt scrotal trauma clinical management, hematocele, 87 intrascrotal hematoma, 87 pathophysiology, testicular dislocation, 86 testicular rupture, BPH. See Benign prostate hyperplasia (BPH) Brisk hematuria arteriovenous malformation, clinical management, clinical presentation, 170 diagnosis, treatment, ureteroarterial fistulas, 168 Burns, genital, 89, C Calcium channel blockers, 232 Capillary leak, 4 Cardiogenic shock clinical management, 6 etiology, 4 Chemotherapeutic agent-induced hemorrhagic cystitis, 183 Chlamydia trachomatis, 125 Class 1 shock, 3 Cloacal exstrophy antenatal diagnosis, 300 clinical management, 303 male neonate with, 297, 299 Color Doppler ultrasound for acute scrotum, 210 external genitalia, 90 testicular trauma, 87, 90 Computed tomography (CT) pyelonephritis, 111 renal injuries, 25

3 renal pelvis laceration, 43 urethral trauma, 78 ureteral calculus, ureteral injury, bladder injury (see CT cystography) Congenital adrenal hyperplasia (CAH), 305, 309, 311 Congenital UPJ obstruction diagnosis, management, 244 presentation, 243 Conventional cystography, 59, Corticosteroids, 231 CT. See Computed tomography (CT) CT cystography bladder perforation, bladder trauma, Cyclooxygenase (COX), 231 Cystoscopy, 185 D Devitalized renal parenchyma, 28, 29 Diabetes mellitus penile prosthesis infection risk, 134 renal colic, 224 Disligation of ureter, 289 Disorders of sex development (DSD) Chicago Consensus statement, 305, 306 classification, 305, 306 definition, 305 diagnosis history, 308 imaging studies, karyotyping, 309 laboratory studies, molecular genotype analysis, physical examination, 308 evaluation, 305, follow-up care, 311 incidence of, 305 management, masculinization score, 308, 309 Dysplasia, renal, 314, 315 E E. coli epididymo-orchitis, 128 urinary tract infections, 106 Emphysematous pyelonephritis classification, 117 diagnosis, infectious etiologies, 224 pathophysiology, 116 treatment, Endoscopic management prostatic abscess transurethral drainage, 126 renal venous malformation, 241 traumatic ureteral injuries, upper urinary tract obstruction, 245 ureterovaginal fistula, 275 urethral trauma, 80 Endovascular stent, 35 Enterocystoplasty, Epididymis, 207, 209 Epididymo-orchitis abscess, 128, 130 acute scrotum clinical presentation, treatment, 213 diagnosis, 128 etiology, indications, 130 microbiology, 128 physical examination, presentation and differential diagnoses, 127 radiologic evaluation, 128, 129 testicular infarction, 128 treatment, 128, 130 Erectile dysfunction (ED). See also Penile prosthesis infection drug-induced priapism, 196 pelvic fracture urethral injury and incontinence, 80 prevalence, 133 Erectile function after priapism, 203 European Organization for Research and Treatment of Cancer (EORTC), radiation toxicity, Exstrophy epispadias complex anatomic features, , 300 antenatal diagnosis, congenital defects, 297 incidence, operative techniques bladder exstrophy, cloacal exstrophy, 303 preoperative care, 301 External genitalia, trauma AAST staging, 85, 86 penile injury clinical management, initial evaluation, pathophysiology, penetrating trauma, scrotum and testicles clinical management, initial evaluation, pathophysiology, split-thickness skin grafts, 98 Extracorporeal shock wave lithotripsy, 234 Extraperitoneal bladder ruptures, 61 Extravaginal torsion testicular, 207, 208 F Female pelvis anatomy, 283 Female urethra anatomy, 252, 253 Fistula formation after bladder trauma,

4 336 Flank pain, 224 Focused assessment with sonography for trauma (FAST), 61 Foley catheter, 59, 64 Formalin instillation, Fournier s gangrene clinical history, 142 coverage STSG, 146, 147 VAC, 145, 146 definition, 141 diagnosis, emergent management antibiotics, debridement, 144 scrotal defect, 145 surgical emergency, etiology, pathogenesis, 142 postoperative management, prognosis, signs and symptoms, 142 G Genital burns clinical management, pathophysiology, 89 Genitourinary injury prevention, 18 Gerota s fascia, 31, 32 Gonococcal urethritis, 127 Gunshot wounds (GSW) etiology, 39 penile, 92 scrotum, H Haddon s matrix, HBO2 therapy. See Hyperbaric oxygen (HBO 2 ) therapy Hematocele, 87 Hematuria, 42 Hemodynamic instability with shock, 27 Hemorrhagic cystitis (HC) antiviral therapies, 190 causes, 183 chemotherapeutic agent-induced, 183 classification, 181 clinical presentation, cystoscopy, 185 emergency options embolization/surgical ligation, 189 temporary urinary diversion, 189 total cystectomy, etiology and risk factors, 181, 183 future therapies, 190 HBO 2 therapy, intravesical therapies, investigations, 185 management first-line therapy, second-line therapy, 187 pathology, 184 prophylaxis, 186 radiation-induced, 183 radiological imaging, RTOG/EORTC classification, 181, 182 viral infection-induced, Henoch Schonlein purpura, 216 Human chorionic gonadotropin (hcg), 309 Hyperbaric oxygen chamber, 187 Hyperbaric oxygen (HBO 2 ) therapy, Hypertension (HTN), 34 Hypoadrenal shock, 4 Hypovolemic shock clinical management, 4 6 etiology, 3 Hysterectomy, abdominal, 66 I Iatrogenic ureteral injuries. See also Ureteral injury, pelvic surgery causes, 283 factors inducing, 283 injury recognition, 283 to urinary bladder, Ileal interposition, 291 Impaired detrusor contractility, 254, 255 Incontinence, after pelvic fracture urethral injury, Inflatable penile prosthesis (IPP), 133, 134 Injury prevention definition, 10, 14 evaluation programs, genitourinary injury prevention, 18 Haddon s strategies, 15 historical chronology, impact of trauma, 10 implementation methods education, 16 enforcement, engineering, 17 mortality, causes of, prevalence, 9 strategies and analysis, unintentional injury, 10 urethral and bladder injuries, 9 Intersex. See Disorders of sex development (DSD) Interstitial bladder rupture, 59 Intracorporeal laser lithotripsy, Intraperitoneal bladder ruptures, 57, 59 Intrascrotal hematoma, 87 Intravenous pyelogram, 43 Intravenous urography (IVU), 110, 154, 227 Intravesical therapies, L Laparoscopy bladder trauma, 66 67

5 337 vesicovaginal fistula (VVF), 270 Large pelvic hematomas, 61, 62 Long ureteral defects, 51 M MAG-3 (technetium-99m mercaptoacetyltriglycine), 317 Magnetic resonance imaging disorders of sex development, urethral trauma, 79 Male urethra anatomy, 252 Management of Myelomeningocele Trial (MOMS), 326 Mitrofanoff channels, 326 N Narcotics, for renal colic, Neisseria gonorrhoea, 125 Neobladder rupture, 68 Nephrostomy, 287 Neurogenic shock, 4 Noncontrast computed tomography, Nongonococcal urethritis, 127 Nonsteroidal anti-inflammatory drugs (NSAIDs), O Opioid receptors, 231 Orchitis. See Epididymo-orchitis Overactive bladder (OAB) syndrome, 232 P Papillary necrosis, 242 Pelvis.See also Ureteral injury, pelvic surgery anatomy, female, 283 risk areas for bladder injury, 67 Penetrating penile trauma amputation, 95, avulsion injuries, 93 bites and burns, 93 fracture/penetrating injury, 94 gunshot and stab wounds, 92, 99 penile fracture, Penetrating scrotal trauma avulsion injuries, 89 bites clinical management, 97 pathophysiology, 89 clinical management, 96 genital burns, 89 gunshot wound, pathophysiology, self-mutilation, 88 stab wounds/lacerations, 88 Penetrating trauma clinical management of penile, epidemiology of bladder, 40 pathophysiology of penile, penile injuries (See Penetrating penile trauma) renal injuries, scrotal trauma (See Penetrating scrotal trauma) Penile prosthesis infection clinical management, clinical presentation, 136 infection risk, 133 pathogenic organism, pathophysiology, prophylaxis, 135 risk factors, salvage procedure, Penile trauma avulsion injuries clinical management, pathophysiology, 93 blunt trauma clinical management, pathophysiology, burns, pathophysiology, gunshot wound, 92 initial evaluation penile amputation, 95 penile fracture/penetrating injury, 94 penetrating trauma clinical management, pathophysiology, penile fracture, self-mutilation, Percutaneous nephrostomy, Perinephric abscess causes, complications, 33 diagnosis, treatment, Perineum burns, 214 Fournier s gangrene, 141, 142 Phenylephrine, 200 Phosphodiesterase type 5 inhibitors, 204 Plain fi lm radiography for diagnosis of DSD, Posterior urethral valves (PUV) anatomy, 313 clinical presentation, dysplasia, 314, 315 etiology of, 313 evaluation, 317, 318 follow-up management bladder function optimization, ESRD, 321 long-term, 320 vesicoureteral reflux, 321 membranes location, 313 pathophysiology, treatment cutaneous ureterostomy or pyelostomy, 320 endoscopic ablation, 319, 320 Fogarty embolectomy balloon technique, 319 upper tract diversion, 320 Young s classification, 313

6 338 Posterior urethra trauma delayed reconstruction, diagnosis, initial management, prevalence, 77 Prader classification, DSD, 308 Priapism American Urological Association Guidelines Al-Ghorab shunt, 200, 202 clinical and blood gas fi ndings, percutaneous shunts, 200, 201 phenylephrine, 200 proximal shunts, 200, 203 treatment, T-shunt, clinical management, definition and classification, 196 derivation, 195 epidemiology, erectile function and duration, 203 etiology drugs, hematologic disorders, 197 idiopathic, 198 malignant, 198 metabolic disorders, pathophysiology, ischemic and arterial, 198 pharmacotherapy, 204 phosphodiesterase type 5 inhibitors, 204 shunts, Prostatic abscess clinical presentation, 124 radiologic evaluation, 124, 125 treatment, 124, 126 Prostatitis, acute bacterial. See Acute bacterial prostatitis Proximal ureter injury, 41 Pseudoaneurysm (after renal injury), 33 Psoas hitch, 290 PUV. See Posterior urethral valves (PUV) Pyelonephritis, 224 imaging, pathogenesis, 105 pathophysiology, treatment hospitalization, oral antibiotic, 108 parenteral antibiotic therapy, 109 trimethoprim-sulfamethoxazole (TMP-SMX), urosepsis, 110 Pyonephrosis, 116 R Radiation-induced hemorrhagic cystitis, 183 Radionuclide scintigraphy, 25 Renal abscess presentation and diagnosis, 112 treament, Renal artery embolism/infarction acquired, etiologies, 153, 154 spontaneous infarction diagnosis, 154 incidence, prognosis, 155 treatment, Renal colic abscess, 224 differential diagnoses, 221, 223 etiologies infectious, 224 intraperitoneal, 224 obstructive, 225 extracorporeal shock wave lithotripsy, 234 history and physical examination, 225 imaging intravenous urography, 227 noncontrast computed tomography, plain film radiography, ultrasonography, 228, 230 laboratory studies, medical management alpha-adrenergic antagonists ( a-blockers), alternative treatments, 232 anticholinergics, 232 anti-inflammatory drugs, calcium channel blockers, 232 considerations, 233 corticosteroids, 231 stone passage, percutaneous nephrostomy, pregnancy, urgent intervention in, 234 pyelonephritis, 224 retrograde ureteral stenting, 233 ureteroscopy and intracorporeal laser lithotripsy, vascular etiologies aneurysm, hemorrhage, infarction, 222 Renal hemorrhage bleeding disorders, 166 cystic, idiopathic, 166 inflammatory/infectious, 166 neoplastic, vascular, Renal infarction, spontaneous diagnosis, 154 incidence, prognosis, 155 treatment, Renal injuries classification and incidence, complications hypertension, 34 perinephric abscess/urinoma, 34 renal insufficiency, 34 secondary hemorrhage, 33 delayed radiographic imaging, 33 demographics, 22

7 devitalized renal parenchyma, 28, 29 endovascular stent, 35 hematuria, high-grade injuries, 28 history and physical examination, 24 initial assessment, nonoperative management, operative technique, 30 penetrating trauma, radiographic evaluation, renal vessels isolation Gerota s fascia, 31, 32 loop occlusion, 31 midpole renal injuries, parenchymal injuries, partial nephrectomy, renovascular injuries, shock and retroperitoneal hematoma, 27 superselective angioembolization, surgical management, 27 urine extravasation, 28, 29 Renal insufficiency, 34 Renal papillae, 241 Renal vein thrombosis (RVT) in adults diagnosis, 157 etiology, 156 presentation, prognosis, 158 therapy, in children diagnosis, 159 etiology, 158 presentation, 158 treatment, 159 Renovascular injuries, Resuscitation fluid resuscitation, 7 hemodynamic monitoring, 6 8 Retrograde cystography, 328 Retrograde pyelography, 25 Retrograde ureteral stenting, 233 Retroperitoneal fibrosis (RF) management, presentation, 248 Retroperitoneal hematoma, 27 Retroperitoneal hemorrhage (RPH) adrenal causes neoplastic, 164, systemic, 164, clinical sequelae, diagnosis, 171 etiology, 163 management, presentation, renal causes bleeding disorders, 166 cystic, idiopathic, 166 inflammatory/infectious, 166 neoplastic, vascular, treatment, Ribavirin, intravenous, 190 RPH. See Retroperitoneal hemorrhage (RPH) RVT. See Renal vein thrombosis (RVT) 339 S Scrotal avulsion, pathophysiology, 89 Scrotum. See also Acute scrotum; Scrotum and testicles burns, 214 Fournier s gangrene, 141, 142, 145 Scrotum and testicles. See also Penetrating scrotal trauma blunt scrotal trauma clinical management, pathophysiology, clinical management, genital burns clinical management, pathophysiology, 89 initial evaluation, pathophysiology, penetrating scrotal trauma clinical management, 96 pathophysiology, scrotal avulsion, pathophysiology, 89 vulvar trauma clinical management, 96 initial evaluation, pathophysiology, 87 Secondary hemorrhage, 33 Seldinger technique, 258 Self-mutilation penile, scrotum, 88 Sepsis syndrome, 110 Septic shock clinical management, 6 etiology, 3 4 Shock classification, 3 clinical management cardiogenic shock, 6 hypovolemic shock, 4 6 primary, 4 septic shock, 6 definition, 3 etiology, 3 4 hemodynamic monitoring, 6 8 resuscitation, 7 Spina bifida bladder perforation, 328 bladder stones, definfition, 325 management, 329 metabolic disturbances, 327 pathogenesis, 325 prenatal intervention,

8 340 Spina bifida (cont.) radiologic diagnosis, urologic treatment, 326 Spinal shock, 254 Split-thickness skin grafting (STSG), 146, 147 Spontaneous renal infarction. See Renal infarction, spontaneous Stab wounds, etiology, 39 Stone passage, Stress urinary incontinence (SUI), 266 STSG. See Split-thickness skin grafting (STSG) Superselective angioembolization (SSA), Suprapubic cystostomy after urethral injury, 64 open, 258 punch, 258 Suprapubic tube, 64 Systemic inflammatory response syndrome (SIRS), 3 4 T Temporary urinary diversion, 189 Testicle dislocation, 86 infarction, 128 rupture, trauma clinical presentation, in adults, treatment, 214 Thigh pouches, 144, 145 Thrombectomy/thrombolysis, RVT, 158 Transureteroureterostomy, 49 50, Traumatic ureteral injuries anatomy, 41 clinical presentation, 42 delayed diagnosis, 44 direct ureteral inspection, 44 epidemiology blunt injuries, GSW/stab wounds, 39 penetrating injury, 40 etiology, hematuria, 42 operative techniques anterior tubularized bladder wall fl ap, endoscopic management, long ureteral defects, 51 primary repair, 47 principles, 46 transureteroureterostomy, ureteroneocystostomy, ureteropyelostomy/ureterocalycostomy, ureteroureterostomy, 47 vesico-psoas hitch, 48, 49 postoperative management, radiologic imaging, surgical management complication, injury location, 46 repair timing, staging, 44 Trimethoprim-sulfamethoxazole (TMP-SMX), Tunica albuginea, 211 U Ultrasound disorders of sex development, 308 posterior urethral valves, 315, 316 renal colic, 228, 230 renal injuries, 25 Unintentional injury, Upper tract hematuria. See Brisk hematuria Upper urinary tract obstruction clinical presentation, 239 congenital UPJ obstruction diagnosis, management, 244 presentation, 243 fungal bezoars presentation, 243 treatment, 243 imaging, 240 laboratory evaluation, luminal clots, 241 papillary necrosis management, 242 presentation, 242 retroperitoneal fibrosis (RF) management, presentation, 248 urothelial carcinoma diagnosis and management, 247 presentation, 247 ureteral strictures diagnosis, 245 management, presentation, 245 Ureteral injuries, traumatic. See Traumatic ureteral injuries Ureteral injury, pelvic surgery anatomic surgical considerations, complications, 291 drainage issues, 291 endoscopic stenting, 287 epidemiology and pathogenesis, 283 incidence of, 283 management selection, postoperative evaluation, 291 prevention, recognition and evaluation delayed signs, 285 intraoperative, 285 radiography, reconstructive techniques anterior bladder wall flap, 290 disligation, 289

9 341 ileal interposition, 291 primary closure, 289 principles, psoas hitch, 290 reimplantation, 289 transureteroureterostomy, ureteroureterostomy, 290 stenting, 284 temporary urinary diversion, ureteropyelography, 286 Ureteral strictures diagnosis, 245 management, presentation, 245 Ureteroarterial fistulas clinical management, clinical presentation, 170 diagnosis, etiology, 168 treatment, Ureteroneocystostomy, Ureteropyelostomy/ureterocalycostomy, Ureteroscopy, Ureteroureterostomy, 47, 290 Ureterovaginal fistula (UVF) assessment and investigation, 274 definition and etiology, management diagnosis, 275 endoscopic techniques, 275 surgical repair, prevention, 274 Urethral catheterization, 257 Urethral injuries, prevalence, 9 Urethral trauma anterior urethra blunt trauma, 73 delayed reconstruction, diagnosis, initial management, penetrating trauma, 73 posterior urethra delayed reconstruction, diagnosis, initial management, prevalence, 77 Urethritis, acute bacterial clinical presentation, diagnosis, 125 pathogens, 125 treatment, Urinary tract infections (UTIs) emphysematous pyelonephritis classification, 117 diagnosis, pathophysiology, 116 treatment, perinephric abscess, PUV, 315 pyelonephritis imaging, pathogenesis, 105 pathophysiology, treatment, pyonephrosis, 116 renal abscess presentation and diagnosis, 112 treament, risk factors, 106 xanthogranulomatous pyelonephritis, Urine extravasation, 28, 29 Urosepsis, 110 Urothelial carcinoma (TCC) diagnosis and management, 247 presentation, 247 V VAC. See Vacuum-assisted closure (VAC) Vacuum-assisted closure (VAC), 145, 146 Vaginal surgery, 66 Varicocele, 216 Vesico-psoas hitch. 48, 49, 290 See Psoas Hitch Vesicoureteral reflux (VUR), 321 Vesicovaginal fistula (VVF) bladder injury, 69 Clinical management abdominal approach, extraperitoneal and Intraperitoneal, 270 laparoscopic approach, 270 surgical technique, timing of surgery, 267 vaginal approach, complications, 273 definition and etiology, 263 diagnosis, interposition grafts, pathogenesis, 264 postoperative care, 272 presentation, 265 prevention, stress incontinence, 266 success rates, Viral infection-induced hemorrhagic cystitis, Voiding cystourethrogram (VCUG), 317, 318 Vulvar trauma clinical management, 96 initial evaluation, pathophysiology, 87 X Xanthogranulomatous pyelonephritis (XGP) diagnosis, pathogenesis, 118 treatment,