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• W4254685205 abstract "You have accessJournal of UrologyTrauma/Reconstruction/Diversion: External Genitalia Reconstruction and Urotrauma (including transgender surgery) II1 Apr 2018MP25-05 IS SYSTEMATIC EARLY DRAINAGE RELEVANT TO TREAT URINARY TRACT RUPTURE IN NON-PENETRATING RENAL TRAUMA? RESULTS FROM A MULTICENTER STUDY Ala Chebbi, Anthony Giwerc, Benoit Peyronnet, Lucas Freton, Jonathan Olivier, Quentin Langouet, Marina Ruggiero, Ines Dominique, Clementine Millet, Sebastien Bergerat, Paul Panayotopoulos, Reem Betari, Xavier Matillon, Thomas Caes, Pierre-Marie Patard, Szabla Nicolas, Nicolas Brichart, Laura Sabourin, Kerem Guleryuz, Charles Dariane, Cedric Lebacle, Jerome Rizk, Alexandre Gryn, François-Xavier Madec, Marine Hutin, Benjamin Pradere, Christian Pfister, Gaelle Fiard, and François-Xavier Nouhaud Ala ChebbiAla Chebbi More articles by this author , Anthony GiwercAnthony Giwerc More articles by this author , Benoit PeyronnetBenoit Peyronnet More articles by this author , Lucas FretonLucas Freton More articles by this author , Jonathan OlivierJonathan Olivier More articles by this author , Quentin LangouetQuentin Langouet More articles by this author , Marina RuggieroMarina Ruggiero More articles by this author , Ines DominiqueInes Dominique More articles by this author , Clementine MilletClementine Millet More articles by this author , Sebastien BergeratSebastien Bergerat More articles by this author , Paul PanayotopoulosPaul Panayotopoulos More articles by this author , Reem BetariReem Betari More articles by this author , Xavier MatillonXavier Matillon More articles by this author , Thomas CaesThomas Caes More articles by this author , Pierre-Marie PatardPierre-Marie Patard More articles by this author , Szabla NicolasSzabla Nicolas More articles by this author , Nicolas BrichartNicolas Brichart More articles by this author , Laura SabourinLaura Sabourin More articles by this author , Kerem GuleryuzKerem Guleryuz More articles by this author , Charles DarianeCharles Dariane More articles by this author , Cedric LebacleCedric Lebacle More articles by this author , Jerome RizkJerome Rizk More articles by this author , Alexandre GrynAlexandre Gryn More articles by this author , François-Xavier MadecFrançois-Xavier Madec More articles by this author , Marine HutinMarine Hutin More articles by this author , Benjamin PradereBenjamin Pradere More articles by this author , Christian PfisterChristian Pfister More articles by this author , Gaelle FiardGaelle Fiard More articles by this author , and François-Xavier NouhaudFrançois-Xavier Nouhaud More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2018.02.842AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Management of non-penetrating renal trauma (NPRT) associated with urinary tract rupture (AAST Grade IV-V) is not clearly codified regarding the usefulness of upper tract drainage with stent insertion. The aim of this study was to compare the outcomes of an early upper urinary tract drainage (ED) to a conservative management (CM) after a NPRT with a urinary extravasation at initial CT-scan assessment. METHODS A multicenter retrospective national study was conducted, including all patients treated for renal trauma in 17 centers from 2005 to 2015. Patients who had a urinary extravasation at the initial CT-scan assessment delayed phase were considered for inclusion. Penetrating traumas, hemodynamically unstable patients and those who were initially treated with nephrectomy were excluded. Patients were divided into 2 groups: ED defined by drainage of upper urinary tract of the injured kidney within the 48 hours following the admission and CM. The persistence of urinary extravasation at repeat CT-scan, the need for delayed drainage, length of stay, early and late complications, and specific death related to the current episode of trauma were analyzed. RESULTS Among a total of 1500 kidney trauma over the studied period 268 patients met the inclusion criteria. The median age was 25 years and 158 (79%) patients were male. Clinicians performed an ED with ureteric stent insertion for 69 patients (26%). A persistent urinary extravasation was found in 50 patients (36%) of the CM on the repeat CT in mean delay of 6 days. This persistent leak required a delayed ureteric stent insertion in 23 patients (17%). The mean length of stay was longer after ED 21 days vs. 14 days after CM (p=0,03). There was no difference in complications rate and death related to the trauma between the 2 groups. CONCLUSIONS Our results suggest that conservative management should be considered for the management of renal trauma associated with urinary extravasation at the initial CT-assessment. CM was associated with good outcomes as 83% of the patients didn't required any drainage of their upper tract and the urinary extravasation at repeat CT was still present for 36% of the patients only. Initial clinical monitoring and repeat CT-scan to re-assess the urine leak might be useful and less invasive than a systematic early drainage. © 2018FiguresReferencesRelatedDetails Volume 199Issue 4SApril 2018Page: e327-e328 Advertisement Copyright & Permissions© 2018MetricsAuthor Information Ala Chebbi More articles by this author Anthony Giwerc More articles by this author Benoit Peyronnet More articles by this author Lucas Freton More articles by this author Jonathan Olivier More articles by this author Quentin Langouet More articles by this author Marina Ruggiero More articles by this author Ines Dominique More articles by this author Clementine Millet More articles by this author Sebastien Bergerat More articles by this author Paul Panayotopoulos More articles by this author Reem Betari More articles by this author Xavier Matillon More articles by this author Thomas Caes More articles by this author Pierre-Marie Patard More articles by this author Szabla Nicolas More articles by this author Nicolas Brichart More articles by this author Laura Sabourin More articles by this author Kerem Guleryuz More articles by this author Charles Dariane More articles by this author Cedric Lebacle More articles by this author Jerome Rizk More articles by this author Alexandre Gryn More articles by this author François-Xavier Madec More articles by this author Marine Hutin More articles by this author Benjamin Pradere More articles by this author Christian Pfister More articles by this author Gaelle Fiard More articles by this author François-Xavier Nouhaud More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ..." @default.
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