Early examination and accurate diagnosis in urinary tract injuries are essential to obtain best results from treatment. Extravasation of urine must be prevented or treated immediately. Roentgenographic studies are usually necessary. Of 13 patients with straddle injuries in a five-year period, 11 were treated without surgery, while perineal repair was necessary in only one. Urethrography was needed for diagnosis in but one case. Insertion of an indwelling catheter sufficed for 14 patients with injuries of the pendulous urethra. Thirteen of 15 patients with ruptured or transected injuries of posterior urethra required surgery. All but one of 54 patients with bladder injuries required surgery. Five ureteral injuries caused by gunshot wounds were repaired and splinted with good results. Of 126 patients with renal injuries, 62 were treated with conservative measures. The others required surgery.
Lombardo LJ, Heyman AM, Barnes RW. INJURIES OF THE URINARY TRACT DUE TO EXTERNAL TRAUMA. JAMA. 1960;172(15):1618–1622. doi:10.1001/jama.1960.03020150042008