[Conservative treatment of stage III kidney injuries]

The aim of this study is to evaluate the safety and effectiveness of conservative management in stage III renal trauma.We reviewed the records of 150 patients who presented in our institution with renal trauma between 1986 and 1995.Minor injuries (stage I and II: 100 cases) were treated with expectant management. Only 3 patients required nephrectomy in this group. Stage III injuries were seen in 40 patients. The great majority (85%) were treated conservatively with renal sparing procedures such as endourologic techniques (14 cases), nephrorraphy or partial nephrectomy (20 cases). Total nephrectomy was performed in 15% of the cases and only for severely injured kidney or major associated intraabdominal injuries. In this group, none of the patients suffered from hypertension at follow-up. All patients (10 cases) with pedicle injury (stage IV) required total nephrectomy.Stage III renal trauma with urinary extravasation can safely be treated conservatively.