BACKGROUND

Management of GU injuries requires a systematic approach to imaging and treatment that adheres to established surgical and trauma principles. Establishing the patient's hemodynamic stability is critical to the initial evaluation. Stable patients are afforded a rigorous radiographic evaluation that identifies genitourinary sites of injury and allows for the safe establishment of urinary drainage. Recognizing that intra-abdominal GU injuries are often associated with significant vascular and visceral injuries is essential to determining management priorities. Unstable patients, on the other hand, require rapid surgical evaluation and hemorrhage control.4 Preservation of as much tissue as possible, particularly when dealing with the external genitalia, should be an additional goal for far-forward surgeons. Current combat casualty care principles allow for multiple surgical evaluations along the path of evacuation to tertiary centers outside the theater of operations, where tissue re-evaluation, wound irrigation, further debridement, and definitive treatment can occur.5