Genitourinary injuries associated with pelvic fractures

Pejcic, T.; Lončar, Zlatibor; Rafailovic, Dragutin; Acimovic, M.; Dzamic, Zoran; Hadži-Djokić, Jovan

doi:10.2298/aci1302117p

Cited by 7 publications

(3 citation statements)

References 17 publications

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“…Pelvic fractures resulting in PFUI are high impact injuries with mortality rates between 5–33% ( 4 , 29 , 32 , 36 , 45 , 48 - 53 ). Other associated injuries are common and include: intracranial (40–66.1%), splenic (9.3–37%), colorectal (6.8–29.1%), bladder (2.5–28%), chest (6–16.6%), liver (5.6–19%), lower limb fracture(s) (17%), pulmonary (9.3%), upper limb fracture(s) (3%) and diaphragmatic rupture (3–21%) ( 4 , 32 , 33 , 39 , 52 , 54 - 58 ). Initial medical management should concentrate on resuscitating and stabilising the patient, and then on identifying all associated injuries.…”

Section: Injuries Associated With Pelvic Fracturesmentioning

confidence: 99%

Pelvic fracture urethral injury in males—mechanisms of injury, management options and outcomes

Barratt

Bernard

Mundy

et al. 2018

Transl. Androl. Urol.

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Pelvic fracture urethral injury (PFUI) management in male adults and children is controversial. The jury is still out on the best way to manage these injuries in the short and long-term to minimise complications and optimise outcomes. There is also little in the urological literature about pelvic fractures themselves, their causes, grading systems, associated injuries and the mechanism of PFUI. A review of pelvic fracture and male PFUI literature since 1757 was performed to determine pelvic fracture classification, associated injuries and, PFUI classification and management. The outcomes of; suprapubic catheter (SPC) insertion alone, primary open surgical repair (POSR), delayed primary open surgical repair (DPOSR), primary open realignment (POR), primary endoscopic realignment (PER), delayed endoscopic treatment (DET) and delayed urethroplasty (DU) in male adults and children in all major series have been reviewed and collated for rates of restricture (RS), erectile dysfunction (ED) and urinary incontinence (UI). For SPC, POSR, DPOSR, POR, PER, DET and DU; (I) mean RS rate was 97.9%, 53.9%, 18%, 58.3%, 62.0%, 80.2%, 14.4%; (II) mean ED rate was 25.6%, 22.5%, 71%, 37.2%, 23.6%, 31.9%, 12.7%; (III) mean UI rate was 6.7%, 13.6%, 0%, 14.5%, 4.1%, 4.1%, 6.8%; (IV) mean FU in months was 46.3, 29.4, 12, 61, 31.4, 31.8, 54.9. For males with PFUI restricture and new onset ED is lowest following DU whilst UI is lowest following DPOSR. On balance DU offers the best overall outcomes and should be the treatment of choice for PFUI.

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Section: Injuries Associated With Pelvic Fracturesmentioning

confidence: 99%

Pelvic fracture urethral injury in males—mechanisms of injury, management options and outcomes

Barratt

Bernard

Mundy

et al. 2018

Transl. Androl. Urol.

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“…Approximately 15% of patients with pelvic fractures have associated bladder or urethral injuries [17]. In our study, one patient in group 1 sustained extraperitoneal urinary bladder rupture without secure repair during the pelvic surgery.…”

Section: Discussionmentioning

confidence: 68%

Conventional plate fixation versus minimally invasive modified pedicle screw-rod fixation for anterior pelvic ring fractures

et al. 2019

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There are various methods of fixation for anterior pelvic ring fractures. We report our experience with modified pedicle screw-rod fixation (MPSRF) via a minimally invasive method. Fourteen patients with anterior pelvic ring fracture were treated by internal fixation (conventional plate fixation, n = 7; MPSRF, n = 7). Intraoperative blood loss, operative time, post-operative fracture reduction grading by radiography, and complication rates were compared and statistically analyzed. Patients treated with MPSRF had a shorter operative time (-36 min, P = 0.378) and significantly less blood loss (-264 ml, P = 0.026) than patients in the conventional plate fixation group. Postoperative radiological evaluations were similar between the groups (P > 0.05). The complication rate was lower in the MPSRF group (1/7 patients) than in the plate fixation group (2/7 patients). Modified pedicle screw-rod fixation is a viable treatment for anterior pelvic ring fixation and can reduce blood loss.

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“…Epidemiologic studies have reported that 12% to 62% of patients with pelvic fractures had additional injuries to the thorax, brain, long bones and abdominal organs to include the genitourinary system, spine and the peripheral nervous system. 21,22 Tomislav Pejcic et al 23 studied urethral injuries in 46% of patients and urinary bladder trauma in 12% of patients. In contrast to us, Nan-Ping Yang et al 1 observed the most common injuries associated with pelvic fractures were fractures of lower limbs (21.50%) followed by fractures of the spine/ trunk (20.97%) and fractures of upper limbs (18.18%), fracture of the skull or intracranial injury (17.59%), internal injury of the abdomen and pelvis (11.00%) and internal injury of the chest (7.20%).…”

Section: Discussionmentioning

confidence: 99%

Epidemiology of Pelvic Fractures and Concomitant Injuries- A Cross-Sectional Observational Study

Swain¹,

Rautray²,

Singh³

2018

jemds

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BACKGROUND Pelvic fractures are rare injuries (3-8%) as compared with fractures in other body regions. Often the result of high-energy trauma in young individuals and low-energy injury in older people, pelvic ring fractures are associated with considerable morbidity, high mortality rates and significant cost to the society. MATERIALS AND METHODS This study was a retrospective descriptive study analysis of data of trauma patients with pelvic fractures admitted in the Emergency Room (ER). The diagnosis of a fracture was based on the history, signs and symptoms, visual finding, manual examination and OPG radiographs. Exact determination of site and pattern of bony injury was determined by correlating it radiographically using three dimensional CT scan. RESULTS We conducted this study on 130 patients who presented to the emergency department and diagnosed radiologically to have some type of pelvic fracture. Out of 130 patients, 37.7% were males and 62.3% were females. Majority of fractures were seen in the elderly age group of > 75 years (50.8%). CONCLUSION Pelvic fractures are often the result of high-energy trauma in young individuals and low-energy injury in older people. Often associated with injuries at other multiple sites increasing morbidity and mortality.

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Genitourinary injuries associated with pelvic fractures

Abstract: Genitourinary injuries increase overall mortality in patients with pelvic fracture, compared with traumas without associated GU injuries. These patients require multidisciplinary approach, preferably in tertiary institutions.

Cited by 7 publications

References 17 publications

Pelvic fracture urethral injury in males—mechanisms of injury, management options and outcomes

Pelvic fracture urethral injury in males—mechanisms of injury, management options and outcomes

Conventional plate fixation versus minimally invasive modified pedicle screw-rod fixation for anterior pelvic ring fractures

Epidemiology of Pelvic Fractures and Concomitant Injuries- A Cross-Sectional Observational Study

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