CHAPTER 108 ■ GENITOURINARY TRAUMA R CALEB KOVELL, GREGORY E TASIAN, ROBERT A BELFER INTRODUCTION Genitourinary trauma in children is common with approximately 28,000 children presenting to emergency departments (EDs) in the United States annually with genitourinary injuries Approximately 10% of patients with serious multisystem trauma have genitourinary injuries and 3% of pediatric patients admitted with trauma will have a genitourinary injury Most injuries (90%) are the result of blunt trauma that involves crush injury and acceleration/deceleration forces related to motor vehicle collisions, and falls of high-velocity injuries such as sledding, skateboarding, or skiing The clinical approach to the injured child follows advanced trauma life support guidelines Figure 108.1 provides an algorithm for diagnostic evaluation of pediatric patients with genitourinary trauma Management of genitourinary injuries in the emergency setting generally involves fully identifying the location and extent of the injury, prevention of ongoing injury by establishing urinary drainage and planning for operative procedures, when necessary KEY POINTS The goal of emergency therapy for genitourinary injury is to maximize organ preservation and minimize future morbidity Assessment of the genitourinary system can be undertaken once lifethreatening conditions have been identified and the child has been resuscitated Management of hemodynamically stable children with renal injuries should proceed on the basis of radiographic staging of the traumatic injury RELATED CHAPTERS