Injuries should be suspected with any blunt or penetrating trauma near the GU tract, including any rapid deceleration, which can cause major vascular or parenchymal injury even without specific signs or symptoms. Hematuria of any amount raises the index of suspicion for GU injury, and difficulty with urination can be due to bladder or urethral injury or associated concomitant spinal cord injury. Flank contusions or hematomas, evidence of lower rib fractures, or penetrating flank injuries raise concern for renal injury. Lower abdominal pain, tenderness, ecchymosis, or evidence of a pelvic fracture as well as perineal or scrotal edema is consistent with possible bladder injury. Vaginal bleeding, high-riding prostate, perineal hematoma, and/or blood at the urethral meatus are consistent with urethral disruption.