Characteristics of Traumatic Urogenital Injuries in Emergency Department; a 10-year Cross-sectional Study
Archives of Academic Emergency Medicine,
Vol. 7 No. 1 (2019),
Introduction: Urogenital system injuries (UGIs) are seen in 10% of adult cases with multiple trauma. Although UGIs are rarely life threatening, they can cause major long-term morbidities. This study aimed to evaluate the characteristics of traumatic UGIs in patients who were referred to emergency department following multiple traumas.Â
Methods: This retrospective cross-sectional study was conducted on multiple trauma patients who were presented to emergency department during a 10-year period (2008-2017). All patients with kidney, ureter, bladder, urethra, or external genitalia injuries were studied. The patientsâ€™ data were extracted from their clinical profiles.
Results: Out of the 13598 admitted patients in our trauma center, UGIs were seen in 267 (1.9%) cases. The mean age of patients with UGIs was 27.3 Â± 6.1 years (74.15% male).Â The highest incidence of UGI was seen in those aged between 21 and 30 years (39.7%) and motorcycle accidents (49%) was the most frequent cause of trauma. 221 patients had an unstable situation and were emergently transferred to operation room (13.57% with traumatic kidney injury). The most common injured sites of urogenital system were kidney with 155 (58%) cases, followed by external genitalia with 91 (34.1%) cases. 77.5% of cases were managed conservatively and the rest (22.5%) underwent surgical procedures.
Conclusion: UGIs comprise a low percentage (2%) of traumatic injuries, which are mostly caused by blunt trauma due to road traffic accidents. Kidney is the most common injured organ and UGIs mostly happen in young ages.
- Urogenital system
- acute kidney injury
- wounds and injuries
- multiple trauma
How to Cite
Zou Q, Fu Q. Diagnosis and treatment of acute urogenital and genitalia tract traumas: 10-year clinical experience. Pakistan journal of medical sciences. 2015;31(4):925.
Javanmard B. Recurrent hematuria in renal angio-venous malformation, delay diagnosis and endovascular treatment, a case report. Urology case reports. 2018;16:46.
Razzaghi MR, Rezaei A, Mazloomfard MM, Javanmard B, Mohammadhosseini M, Rezaei I. Successful macrosurgical reimplantation of an amputated penis. Urology journal. 2009;6(4):306-8.
Rahbar Taramsari M, Badsar A, Naghipour M, Dvam F, Shahrami H, Saeidinia A, et al. Assessment of pre-hospital emergency performance in missions of 115 emergency bases of Rasht, Iran. Annals of Biological Research. 2013;4(12):75-81.
Javanmard B, Yousefi MR, Fadavi B, Karkan MF. Retained Surgical Gauze Presenting With Gross Hematuria: A Case Report. Urology journal. 2017;14(5):5027-9.
Aghajanzadeh M, Dehnadi A, Ebrahimi H, Karkan MF, Jahromi SK, Maafi AA, et al. Classification and management of subcutaneous emphysema: a 10-year experience. Indian Journal of Surgery. 2015;77(2):673-7.
Behboudi H, Moghadam RS, Tiefeh N, Karkan MF. Vision disorders in drivers involved in traffic accidents. Journal of ophthalmic & vision research. 2017;12(4):451.
Taramsari MR, Badsar A, Hamrangnejad M, Saeidinia A, Karkan MF. Alcohol Intoxication in Gilan Province Hospital Center of Toxicology, Iran: Demographic, Patterns and Outcome. Archives of Advanced Sciences. 2017;1(1):10-4.
Smith GS, Barss P. Unintentional injuries in developing countries: the epidemiology of a neglected problem. Epidemiologic reviews. 1991;13(1):228-66.
Salimi J, Nikoobakht MR, Zareei M. Epidemiologic study of 284 patients with urogenital trauma in three trauma center in Tehran. Urology journal. 2009;1(2):117-20.
Pereira BMT, De Campos CCC, Calderan TRA, Reis LO, Fraga GP. Bladder injuries after external trauma: 20 years experience report in a population-based cross-sectional view. World journal of urology. 2013;31(4):913-7.
McAninch JW. Genitourinary trauma. Urologic Clinics. 2006;33(1):xiii.
Laal M, Khodadadi M, Zarei M-R. Renal Trauma Management in 8 Cities of Iran. Acta Medica Iranica. 2009;47(1):61-4.
Salimi J, Nikoobakht MR, Khaji A. Epidemiology of urogenital trauma: results of the Iranian national trauma project. Urology journal. 2009;3(3):171-4.
Mirzazadeh M, Fallahkarkan M, Hosseini J. Penile fracture epidemiology, diagnosis and management in Iran: a narrative review. Translational andrology and urology. 2017;6(2):158.
Allameh F, Najafi S, Karkan MF, Haghighatkhah H, Nekuie S. Chromophobe Renal Cell Carcinoma Presented with Wunderlich Syndrome. International Journal of Cancer Management. 2017;10(11).
Sarvestani AS, Zamiri M. Assessment of genitourinary trauma in Southeastern Iran. Trauma monthly. 2013;18(3):113.
Moore L, Clark DE. The value of trauma registries. Injury. 2008;39(6):686-95.
Wynn A, Wise M, Wright MJ, Rafaat A, Wang Y-Z, Steeb G, et al. Accuracy of administrative and trauma registry databases. Journal of Trauma and Acute Care Surgery. 2001;51(3):464-8.
Zargar M, Kalantar Motamedi SMR, Karbakhsh M, Ghodsi SM, Rahimi-Movaghar V, Panahi F, et al. Trauma care system in Iran. Chinese Journal of Traumatology. 2011;14(3):131-6.
Khashayar P, Amoli HA, Tavakoli H, Panahi F. Efficacy of pre-hospital care in trauma patients in Iran. Emergency Medicine Journal. 2010;27(6):430-2.
Zafarghandi M-R, Modaghegh M-HS, Roudsari BS. Preventable trauma death in Tehran: an estimate of trauma care quality in teaching hospitals. Journal of Trauma and Acute Care Surgery. 2003;55(3):459-65.
Sehat M, Naieni KH, Asadi-Lari M, Foroushani AR, Malek-Afzali H. Socioeconomic status and incidence of traffic accidents in metropolitan Tehran: a population-based study. International journal of preventive medicine. 2012;3(3):181.
Paparel P, Nâ€™DIAYE A, Laumon B, CAILLOT JL, Perrin P, Ruffion A. The epidemiology of trauma of the genitourinary system after traffic accidents: analysis of a register of over 43 000 victims. BJU international. 2006;97(2):338-41.
McGeady JB, Breyer BN. Current epidemiology of genitourinary trauma. The Urologic clinics of North America. 2013;40(3):323.
Schmid CW, Schmid DM. Traumatic Injury of the Urogenital System. Head, Thoracic, Abdominal, and Vascular Injuries: Springer; 2011. p. 351-68.
Bagga HS, Tasian GE, Fisher PB, McCulloch CE, McAninch JW, Breyer BN. Product related adult genitourinary injuries treated at emergency departments in the United States from 2002 to 2010. The Journal of urology. 2013;189(4):1362-8.
Terrier J-E, Paparel P, Gadegbeku B, Ruffion A, Jenkins LC, Nâ€™diaye A. Genitourinary injuries after traffic accidents: Analysis of a registry of 162,690 victims. Journal of trauma and acute care surgery. 2017;82(6):1087-93.
Roudsari BS, Sharzei K, Zargar M. Sex and age distribution in transport-related injuries in Tehran. Accident Analysis & Prevention. 2004;36(3):391-8.
Stiell IG, Clement CM, Rowe BH, Schull MJ, Brison R, Cass D, et al. Comparison of the Canadian CT Head Rule and the New Orleans Criteria in patients with minor head injury. Jama. 2005;294(12):1511-8.
Kuo RL, Eachempati SR, Makhuli MJ, Reed Ii RL. Factors affecting management and outcome in blunt renal injury. World journal of surgery. 2002;26(4):416-9.
Santucci R, Wessells H, Bartsch G, Descotes J, Heyns C, McAninch J, et al. Evaluation and management of renal injuries: consensus statement of the renal trauma subcommittee. BJU international. 2004;93(7):937-54.
Kuan JK, Wright JL, Nathens AB, Rivara FP, Wessells H. American Association for the Surgery of Trauma Organ Injury Scale for kidney injuries predicts nephrectomy, dialysis, and death in patients with blunt injury and nephrectomy for penetrating injuries. Journal of Trauma and Acute Care Surgery. 2006;60(2):351-6.
Bariol S, Stewart G, Smith R, McKeown D, Tolley D. An analysis of urinary tract trauma in Scotland: impact on management and resource needs. The Surgeon. 2005;3(1):27-30.
Aragona F, Pepe P, PatanÃ¨ D, Malfa P, D'arrigo L, Pennisi M. Management of severe blunt renal trauma in adult patients: a 10â€year retrospective review from an emergency hospital. BJU international. 2012;110(5):744-8.
Chapple C, Barbagli G, Jordan G, Mundy A, Rodriguesâ€Netto N, Pansadoro V, et al. Consensus statement on urethral trauma. BJU international. 2004;93(9):1195-202.
Hadjizacharia P, Inaba K, Teixeira PG, Kokorowski P, Demetriades D, Best C. Evaluation of immediate endoscopic realignment as a treatment modality for traumatic urethral injuries. Journal of Trauma and Acute Care Surgery. 2008;64(6):1443-50.
Balkan E, Kilic N, Dogruyol H. The effectiveness of early primary realignment in children with posterior urethral injury. International journal of urology. 2005;12(1):62-6.
Brown JB, Fryer MP. Peno-Scrotal Skin Losses, Repaired by Implantation and Free Skin Grafting: Report of Known Normal Offspring:(Preliminary Report on Total and Deep Losses). Annals of surgery. 1957;145(5):656.
Karian LS, Chung SY, Lee ES. Reconstruction of defects after Fournier gangrene: a systematic review. Eplasty. 2015;15.
Wirth GJ, Peter R, Poletti PA, Iselin CE. Advances in the management of blunt traumatic bladder rupture: experience with 36 cases. BJU international. 2010;106(9):1344-9.
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