A urologic emergency is an injury that requires immediate medical attention and can be caused by long-term neglect of an underlying disorder, infection or a recent trauma. Urologic trauma is the term used to describe extreme damage to the genitourinary system and can be caused by an automobile accident, gunshot wounds, or other acts of violence. This system includes the kidneys, ureters, bladder, testes, urethra, or external genitalia, and most traumatic injuries to these organs must be treated with emergency surgery.
Urologic trauma can occur for other reasons as well. For example, the most common urologic injuries in adolescents result from sports. These injuries are fairly uncommon, and people do not always recognize them as emergencies. It is important to understand the signs and seek immediate medical attention, as certain traumas can eventually lead to renal failure, loss of sexual function, and other organ damage.
Common Urologic Emergencies
Urologic emergencies can occur to both men and women of any age. Most urologic conditions do not require immediate medical attention, however, there are a few to be aware of. The most frequent urologic conditions that are considered to be emergencies include:
Testicular torsion occurs when blood vessels to the testicles twist, cutting off blood flow to the testicle. Symptoms of testicular torsion include scrotum or lower abdomen pain, swelling in the testicle, or blood in the semen. In the event of testicle torsion, the blood vessels must be untwisted within six hours to prevent serious damage. If blood flow is not quickly returned, the tissue can die, causing the testicle to atrophy and have to be removed. Torsion primarily occurs in adolescents but is possible in men of any age.
When an erect penis is forcibly bent, a penile fracture can occur. Penile fractures primarily occur during sexual intercourse or vigorous masturbation. However, penile fractures may also be the result of blunt trauma inflicted on the erect penis.
Penile fractures occur due to the rupturing of the tunica albuginea of the corporal body of the penis. Signs of a penile fracture include immediate pain, instant erection loss, and a popping sensation. This is followed by swelling of the penis known as “eggplant deformity.” Those suffering from a penile fracture may also experience pain when urinating and hematuria if the urethra was also damaged. Treatment for penile fractures involves immediate surgery to close the tear where the penis ruptured. The primary goal of treatment is to restore patient’s urinary function and ability to achieve erections.
Acute Urinary Retention
Acute Urinary Retention is the sudden inability to urinate due to a blockage in the bladder or urethra. This condition is typically caused by an obstruction, but it can also result from the nervous system not communicating properly with the bladder. Acute Urinary Retention can be caused by blood clots, bladder stones, benign prostatic hyperplasia, urinary tract infections, prostate cancer, and other bladder conditions. In addition to the inability to urinate, acute urinary retention also causes severe lower abdominal pain, and when left untreated, this condition can lead to bladder damage and kidney failure. To treat acute urinary retention, a urologist will perform emergency catheterization to drain the bladder. Once the bladder is empty, a series of tests will be done to better understand what caused the original blockage, then further treatment may be recommended.
Paraphimosis occurs when the foreskin of uncircumcised males becomes inflamed. This can be the result of trauma to the area, poor hygiene practices or an infection. It primarily occurs in adolescents and senior men who require frequent catheterizations. In the event of paraphimosis, the foreskin retracts, hindering blood flow and causing swelling to the head of the penis. Paraphimosis must be treated immediately, or gangrene and tissue death may develop. To correct paraphimosis, a urologist will work to reduce swelling and return the foreskin to its proper place.
Priapism is a painful erection that lasts longer than four hours. It is important to note that an erection caused by priapism is not associated with sexual arousal. Instead, it is the product of blood getting trapped in the penis after an erection is achieved. This condition is often the result of certain diseases that cause abnormal blood circulation such as leukemia or sickle cell disease. Specific medications and injections used to treat ED can also contribute to the onset of priapism when improper doses are used. To treat the priapism, a urologist will insert a needle into the side of the penis and drain the trapped blood. If left untreated, it can lead to tissue damage, scarring, or loss of ability to get an erection.
Fournier’s Gangrene is a very progressive form of gangrene affecting the genitalia. This condition is fatal in half of all cases and requires immediate medical treatment. Fournier’s Gangrene is commonly linked to patients who suffer from diabetes, alcohol or steroid abuse, immunosuppression, or other infections. This condition causes severe pain throughout the scrotum and penis, as well as tissue death and redness in the affected area. This form of gangrene is often treated by surgically removing the affected tissue and a powerful cycle of antibiotics.
What to Do in the Event of a Urologic Emergency
If you suspect you are suffering from a urologic emergency or any other form of injury, it is important to seek medical attention immediately. Do so by either calling 911 or going to the nearest emergency room. During a urologic emergency, quick treatment is vital to ensure a full recovery and prevent further complications. For more information on what constitutes a urologic emergency, or to schedule an appointment with a urologist, contact Advanced Urology today. Our dedicated staff offers same-day appointments for urgent and emergency situations.