@entity8 management in an urban XXXX centre and implications for urological training.

@entity1 @entity8 @entity130
INTRODUCTION: The aim of this study was to analyse the treatment and management of @entity8 @entity1 presenting to our major @entity130 unit to determine the likelihood of @entity1 needing immediate nephrectomy. METHODS: The @entity130 Audit and Research Network (TARN) database was used to review @entity130 cases presenting to our department between February 2009 and September 2013. Demographic data, mechanism and severity of injury, grade of @entity8 , management and 30-day outcome were determined from TARN data, electronic @entity1 records and imaging. RESULTS: There were a total of 1,856 @entity130 cases, of which 36 @entity1 (1.9%) had a @entity8 . In this group, the median age was 28 years (range: 16-92 years), with 28 @entity1 (78%) having blunt @entity8 and 8 (22%) penetrating @entity8 . The most common cause for blunt @entity8 was road traffic accidents. @entity8 cases were stratified into American Association for the Surgery of @entity130 (AAST) grades (grade I: 19%, grade II: 22%, grade III: 28%, grade IV: 28%, grade V: 0%). All @entity1 with grade I and II injuries were treated conservatively. There were three @entity1 (1 with grade III and 2 with grade IV @entity8 ) who underwent radiological embolisation. One of these @entity1 went on to have a delayed nephrectomy owing to unsuccessful embolisation. CONCLUSIONS: @entity130 @entity1 rarely require emergency nephrectomy. Radiological selective embolisation provides a good interventional option in cases of active bleeding from @entity8 in haemodynamically stable @entity1 . This has implications for @entity130 care and how surgical cover is provided for the rare event of nephrectomy.
