To illustrate how the innovative technique of contrast-enhanced ultrasound (CEUS) can be successfully implemented in the management of traumatic urological injuries, with case examples provided from our centre.

Urological Trauma
Traumatic urological injury occurs in up to 20% of patients with abdominal trauma and can arise as a result of two primary mechanisms; blunt or penetrating trauma. Blunt injuries are the more common cause of urogenital organ damage, and are sustained from a forceful impact on the body secondary to a road traffic accident, fall, sports-related injury, assault, etc. Penetrating trauma consists of injuries which are as a result of an object piercing through subcutaneous tissue, causing damage to underlying structures and organs, such as gunshot injury or stab wounds.

Urological injury can consist of renal trauma, which is commonly classified using the American Association for the Surgery of Trauma (AAST) Organ Injury Scale (Image 1), as well as injury to the ureters, urinary bladder and/or urethra. recognition of the extent and...

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In the age of contrast-enhanced ultrasound, patients who have sustained various categories of urological trauma can be followed up using a ‘safe’ imaging method such as CEUS and do not require the repeated use of ionising radiation; particularly pertinent in young patients and/or those of reproductive age. CEUS has been shown to correlate well with CT findings and, in some cases, provide additional information that CT alone cannot with its advantage of real-time imaging, improved spatial resolution and ability to be performed portably at patients’ bedside. With conventional intravascular and novel endocavitary use, CEUS could provide tailor-made solutions for managing either diagnostic or logistical challenges in managing patients with traumatic urological injuries.