Renal trauma: indications and techniques for surgical exploration

Injury secondary to trauma has become increasingly common in modern society. In the United States, in excess of 55 million trauma patients are evaluated each year, and trauma is the leading cause of mortality in people under the age of 40 years. Of the patients with abdominal trauma, approximately 10% have an injury to the urinary tract. Renal injury, occurring in 1-5% of all traumas, is due primarily to blunt trauma. Advances in the imaging and staging of renal trauma as well as in treatment strategies have decreased the need for surgical intervention and increased renal preservation. Nevertheless, no consensus exists regarding indications and techniques for renal exploration. The goals of treatment include accurate staging, maximal preservation of renal function, and minimal complications. We discuss our current approach in the management of renal trauma.