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2008 Annual Meeting Abstracts

Experience with Genitourinary Polytrauma at an Urban Trauma Center
Raymond M Bernal, David A Kunkle, Jason R Rothman, Paul L Crispen, Bryan T Kansas, Amy J Goldberg*, Jack H Mydlo
Temple University School of Medicine, Philadelphia, PA

Introduction: Patients with penetrating trauma often suffer injuries to multiple organs. Injury patterns associated with multiple GU injuries (GU polytrauma) have not yet been described. We report our experience with penetrating GU polytrauma at a high-volume trauma center.
Methods: We queried our urologic trauma database to identify patients with penetrating GU injuries treated at our institution over a 10-year period. Patients with multiple GU organ injuries were analyzed.
Results: We identified 233 patients with penetrating GU injuries. Of these, 12% (27/233) were found to have simultaneous injury to more than one urologic structure. Notably, patients with injuries to the penis/urethra (51%) or scrotum (35%) demonstrated the highest incidence of GU polytrauma while kidney injuries (6%) were least likely to have a separate concurrent urologic injury. Of patients with multiple injuries, coincident involvement occurred most commonly in the following combinations: scrotum-penis/urethra (N=16, 59%), ureter-bladder (N=4, 15%), kidney-bladder (N=3, 11%), and kidney-ureter (N=2, 7%). Surgical reconstruction in stable trauma patients was not complicated by multiple GU injuries.
Conclusions: In our experience, GU polytrauma occurred in 12% of patients suffering penetrating urological injuries. GU polytrauma was most commonly identified in patients with injuries involving the external genitalia. This data underscores the importance of a thorough genitourinary tract evaluation for all patients with penetrating GU trauma. A high index of suspicion is necessary to avoid missed urological injuries.
Incidence of Genitourinary Polytrauma Stratified by Affected Structure
Injured StructureNo. Total InjuriesNo. with Second GU InjuryIncidence of GU Polytrauma
Kidney9966%
Ureter38718%
Bladder42717%
Penis/Urethra351851%
Scrotum461635%

 

 

 
     
     
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