AB115. 128. A 10-year review of genito-urinary injuries in pelvic and acetabular trauma
Orthopaedic Session I

AB115. 128. A 10-year review of genito-urinary injuries in pelvic and acetabular trauma

Rosie Colgan, Nikita Rajiv Bhatt, Rajiv Merchant, Niall Davis, Michael Leonard, Brendan O’Daly, Rustom Manecksha, John Quinlan

1Department of Trauma and Orthopaedics, 2Department of Urology, Tallaght Hospital, Dublin, Ireland

Background: Urological trauma can be fatal and can lead to long-term disability. Eight percent of urological trauma is associated with pelvic fractures. The aim was to report the incidence of urological injuries in pelvic and acetabular (P&A) fractures and to investigate associations between P&A fractures and urological injury patterns. A further aim was to prospectively evaluate P&A referrals for adherence to British Orthopaedic Association Standards for Trauma (BOAST) guidelines over a 12-month period.

Methods: A retrospective review of urological injuries in P&A fractures was performed from January 2006–December 2016 in the national pelvic trauma centre. Patient demographics, mechanism and details of injuries were recorded. P&A referrals were prospectively monitored in 2016 and reviewed for adherence to guidelines.

Results: The incidence of urological trauma in P&A fractures was 2.4% (n=28/1141). Median patient age was 45 years (range, 19–85 years) and the M:F ratio was 2.1:1. The most common injury was urethral (n=15, 53%), followed by bladder (n=11, 36%) and kidney (n=5, 18%). Bladder and urethral injuries were associated with high-energy pelvic trauma. Renal injuries were associated with acetabular fractures in isolation and in combination with pelvic trauma (P=0.01). In 2016, there were 176 P&A referrals of which 19 patients had suspected urotrauma (n=5, visible haematuria; n=2, non-visible haematuria; n=11, trauma imaging); of which 47% (9/19) had no urological investigations performed.

Conclusions: Urological injuries in P&A trauma may be underreported due to inadequate evaluation, and diagnostic investigations in these patients. We advocate guideline-based evaluation of urological injuries in P&A trauma to avoid the significant long-term morbidities associated with misdiagnosis.

Keywords: Pelvic; trauma; urological; injury

doi: 10.21037/map.2018.AB115

Cite this abstract as: Colgan R, Bhatt NR, Merchant R, Davis N, Leonard M, O’Daly B, Manecksha R, Quinlan J. A 10-year review of genito-urinary injuries in pelvic and acetabular trauma. Mesentery Peritoneum 2018;2:AB115. doi: 10.21037/map.2018.AB115