TY - JOUR
T1 - Lower urinary tract injuries in patients with pelvic fractures at a level 1 trauma center - an 11-year experience
AU - Rehné Jensen, Lasse
AU - Røder, Andreas
AU - Possfelt-Møller, Emma
AU - Singh, Upender Martin
AU - Aagaard, Mikael
AU - Evald Nielsen, Allan
AU - Svendsen, Lars Bo
AU - Penninga, Luit
PY - 2023
Y1 - 2023
N2 - 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.
AB - 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.
KW - Fractures, Bone/complications
KW - Humans
KW - Pelvic Bones/injuries
KW - Retrospective Studies
KW - Rupture
KW - Trauma Centers
KW - Urethra/injuries
KW - Urinary Bladder
UR - http://www.scopus.com/inward/record.url?scp=85141371463&partnerID=8YFLogxK
U2 - 10.1080/21681805.2022.2141311
DO - 10.1080/21681805.2022.2141311
M3 - Journal article
C2 - 36322390
SN - 2168-1805
VL - 57
SP - 102
EP - 109
JO - Scandinavian Journal of Urology
JF - Scandinavian Journal of Urology
IS - 1-6
ER -