Lower urinary tract injuries in patients with pelvic fractures at a level 1 trauma center - an 11-year experience

Lasse Rehné Jensen*, Andreas Røder, Emma Possfelt-Møller, Upender Martin Singh, Mikael Aagaard, Allan Evald Nielsen, Lars Bo Svendsen, Luit Penninga

*Corresponding author af dette arbejde
2 Citationer (Scopus)

Abstract

BACKGROUND: Urological injuries can occur in patients with pelvic fractures. Treatment recommendations lack solid evidence and is often pragmatical. There is a continuous need to describe short- and long-term morbidity following lower urinary tract trauma.

OBJECTIVE: To describe incidence, diagnosis, treatment, and morbidity following lower urinary tract injuries in pelvic fractures.

PATIENTS AND METHODS: Retrospective study including patients with pelvic, including acetabular, fractures admitted to a Level I Trauma Centre covering 2.8 million citizens between 2009 and 2020. Outcome measurements comprised primary management, treatment trajectory, short- and long-term complications and outcomes.

RESULTS: A total of 39 (5%) patients with pelvic fractures had concomitant urethral and/or bladder injuries, and one patient with an acetabular fracture had a bladder injury. The management of urethral injuries varied vastly, and complete urethral ruptures were associated with severe short- and long-term complications. Only one patient with bladder injury experienced severe long-term complications.

CONCLUSIONS: Management of lower urinary tract injuries in patients with major pelvic fractures remains a major challenge. Special attention should be focused on urethral injuries where we uncovered an unsystematic treatment and follow-up even in a highly experienced centre, although this is also attributed to complicated multidisciplinary patient trajectories. There is a continuous need to reduce long-term complications following urethral trauma which should be addressed in multicenter studies.

OriginalsprogEngelsk
TidsskriftScandinavian Journal of Urology
Vol/bind57
Udgave nummer1-6
Sider (fra-til)102-109
Antal sider8
ISSN2168-1805
DOI
StatusUdgivet - 2023

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