Penetrating high-velocity genitourinary injuries. Part I. Statistics mechanisms, and renal wounds.

As a consequence of missile-tissue energy exchange, high-velocity missile wounds necessitate wide surgical debridement because of severe tissue contusion distant from the wound tract. A missile tract mentally projected by the physician through the urologic tract demands appropriate investigation. The approach to urologic surgery may be primarily determined by the wound tract since this has to be debrided anyway. Ureteral filling on an intravenous pyelogram will save valuable time at surgery. High-velocity penetrating renal injury demands an aggressive surgical approach to obviate later complications.