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

N1 - Publisher Copyright: © 2022 Acta Chirurgica Scandinavica Society.

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 - bladder

KW - lower urinary tract

KW - Pelvic fracture

KW - trauma

KW - urethra

U2 - 10.1080/21681805.2022.2141311

DO - 10.1080/21681805.2022.2141311

M3 - Journal article

C2 - 36322390

AN - SCOPUS:85141371463

VL - 57

SP - 102

EP - 109

JO - Scandinavian Journal of Urology

JF - Scandinavian Journal of Urology

SN - 2168-1805

IS - 1-6

ER -