Citation

Terrier JE, Paparel P, Gadegbeku B, Ruffion A, Jenkins LC, N'Diaye A. J. Trauma Acute Care Surg. 2017; 82(6): 1087-1093.

Affiliation

1 Department of Urology, Centre Hospitalier Lyon Sud, Lyon (France) 2 UMR Epidémiologique et de Surveillance Transport Travail Environnement. IFSTTAR (French institute of science and technology for transport, spatial planning, development and networks), Université Lyon1, Universités de Lyon, UMR_T 9405, Case n° 24, 25 Avenue François Mitterrand, 69675 BRON Cedex 3 Department of Urology, The Ohio State University, Columbus, Ohio, USA.

Copyright

(Copyright © 2017, Lippincott Williams and Wilkins)

DOI

10.1097/TA.0000000000001448

PMID

28328677

Abstract

BACKGROUND: Traffic accidents are the most frequent cause of genitourinary injuries (GUI). Kidney injuries following trauma have been well described. However, there exists a paucity of data on other traumatic genitourinary injuries following traffic accidents. The objective of this study was to analyze the frequency and type of all genitourinary injuries, by user category, following traffic accidents.

METHODS: Patient cases were extracted from the trauma registry of the French department of Rhone from 1996 to 2013. We assessed the urogenital injuries presented by each of road user's categories. Severity injuries were coded with the Abbreviated Injury Scale (AIS) and the Injury Severity Score (ISS). Kidney trauma was mapped with the classification of the American Association for the Surgery of Trauma (AAST). Multivariate prediction models were used for analysis of data.

RESULTS: Of 162 690 victims, 963 presented with genitourinary injuries (0.59%). 47% were motorcyclists, 22% were in a car, 18% on bicycles, and 9% were pedestrians. The most common organ injury was kidney (41%) followed by testicular (23%). Among the 208 motorists with a GUI, kidney (70%), bladder (10%) and adrenal gland (9%) were the most frequent lesions. Among the 453 motorcyclist victims with GUI, kidney (35%) and testicular (38%) traumas were the most frequent and 62% of injuries involved external genitalia. There were 175 cyclists with GUI, 70% of injuries involved external genitalia; penile traumas (23%) were the most frequent. In total, there were 395 kidney injuries, most being low grade. According to the AAST kidney injuries were: grade I - 59%, grade II - 11%, grade III - 16%, grade IV - 9%, grade V - 3% and 2% indeterminate.

CONCLUSIONS: Genitourinary injury is an infrequent trauma following traffic accidents, with kidneys being the most commonly injured. Physicians must be maintain a high awareness for external genitalia injuries in motorcyclists and cyclists. LEVEL OF EVIDENCE: Prognostic and epidemiologic study, level II.

Language: en