doiSerbia

Genitourinary injuries associated with pelvic fractures

Pejčić Tomislav (Clinical Center of Serbia, Urological Clinic, Belgrade)
Lončar Zlatibor (Clinical Center of Serbia, Clinic for Urgent Surgery, Belgrade)
Rafailović Dragutin (Clinical Center of Serbia, Urological Clinic, Belgrade)
Aćimović Miodrag (Clinical Center of Serbia, Urological Clinic, Belgrade)
Džamić Zoran (Clinical Center of Serbia, Urological Clinic, Belgrade)
Hadži-Đokić Jovan (Serbian Academy of Sciences and Arts, Belgrade)

Introduction: Pelvic fractures represent approximately 3% of all skeletal injuries. About 15% of patients with pelvic fractures have associated bladder or urethral injuries. The most common causes of pelvic fracture are motor vehicle accidents, motorcycle crashes, motor vehicles striking pedestrians, and falls. Material and methods: Retrospective study included the patients treated in the Emergency Center, Clinical Center of Serbia, Belgrade, between 2000 and 2009. Of 7445 patients, there were 894 injuries of the urinary tract and 376 pelvic fractures; 55 patients with pelvic fractures (14.6%) had bladder or urethral injuries. There were 31 patients with bladder injuries, 22 patients with urethral injuries, and two patients with associated injuries of the posterior urethra and the bladder neck. Results: The bladder injuries were treated by surgical exploration, cystostomy, suture of the bladder lesions and urethral catheterization. Urethral injuries were treated by primary cystostomy and urethral reconstruction and catheterization in 18 patients (82%), while cystofix-cystostomy was performed in four patients (18%). Discussion: 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.

Keywords: genitourinary trauma, pelvic fracture, bladder injuries, urethral injuries