Acta chirurgica Iugoslavica 2013 Volume 60, Issue 2, Pages: 117-120
https://doi.org/10.2298/ACI1302117P
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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