Simultaneous upper and lower urinary tract injury from external trauma.

We found simultaneous upper and lower urinary tract injury to be rare, being present in 10 of 2,310 patients (0.4%). Multiple associated injuries were present in all patients (average 4.4 per patient). In 3 patients both upper and lower urinary tract injuries were minor, and 1 patient died of associated injuries. In 4 patients one of the urinary injuries was significant and the other minor, and 2 of these patients died. In 3 patients both urinary injuries were significant, and all 3 died of associated injuries. A comprehensive urologic evaluation was required in all 10 patients because of their severe associated multiple injuries.