Routine Urology Consultation and Follow-up After Pediatric Blunt Renal Trauma is Likely Unnecessary

This study examines the outcomes of high-grade renal trauma in pediatric patients and evaluates the intervention rate. In our hospital, we routinely consult urology on all high-grade injuries. We anticipated minimal intervention, casting doubt on the need for routine urology consultation and follow-up. We conducted a retrospective review at a single pediatric trauma center from January 2018 to June 2023, focusing on patients with severe (grade III-V) renal injuries. Data collected included demographics, trauma-related variables, hospital course, interventions, and follow-up. When the grade was not readily available in the electronic medical record, we had a board-certified pediatric radiologist review the imaging and provide the grade. Follow-up was included only if it was with a pediatric urologist. There were 92 patients that met our inclusion criteria. Of these, 47 were grade III, 32 were grade IV, and 13 were grade V. Six (6.5%) patients required inpatient renal stent procedures. Follow-up occurred in 55/92 (60%) patients with a pediatric urologist. Follow-up by grade is as follows: 22/47 (47%) grade III, 22/32 (69%) grade IV, and 11/13 (85%) grade V. Overall 5.8% of patients required antihypertensive medications and this was more likely as injury grade increased. All stents were removed outpatient and there were 3 (3.3%) additional outpatient interventions, all in patients that were symptomatic. Given the low prevalence of interventions after discharge, routine consultation and follow-up with urology is likely unnecessary in the absence of an inpatient urologic procedure during the index hospitalization. Patients with high-grade injuries should instead follow up with a trauma clinic or general provider with urology follow-up based on symptoms. Retrospective Review. Level III. •Less than 50% of patients with grade III renal trauma injuries follow up in urology clinic despite current local guidelines that all high grade (AAST grade III-V) renal injuries follow up in urology clinic•Hypertensive medication while inpatient that is continued on discharge is rare in high grade renal trauma with only a total of 5 patients (5.8%) in our study requiring it.•Urinalysis in outpatient clinics following renal trauma are not likely to lead to further intervention with none of the urinalysis in our study leading to intervention•The charge for a urology outpatient visit is $325.36 and a complete retroperitoneal ultrasound (kidneys and bladder) is $488.80. That is a to