Traumatic urologic injuries in Ile-Ife, Nigeria

In a developing country with limited healthcare resources, traumatic injuries and their management pose a significant challenge to healthcare delivery.

To highlight the challenges in the management of traumatic urologic injuries in patients in our setting.

Patients presenting with traumatic injuries to the urinary tract, between January 1996 and December 2005, in a University Teaching Hospital in Southwestern Nigeria were the subjects of this study.

Clinical records of patients who had such injuries were reviewed.

Ninety injuries occurred in 86 patients including 77 males and 9 females aged 14-68 years. Fourteen (15.5%) of the injuries involved the kidneys, urinary bladder was involved in 23 (25.6%) and the male urethra in 53 (58.9%) injuries. The mechanisms of injury were road traffic accidents in 52 (60.5%) patients, straddle injuries in 18 (20.9%), trauma to the back in 8 (9.3%), falls from a height in 6 (7.0%) and gunshot injuries in 2 (2.3%) patients. Associated injuries include pelvic fractures in 33 (38.4%) patients, limb bone fractures in 13 (14.1%), intestinal injuries in 12 (13.0%) and spinal injuries in 8 (8.7%) patients. In most patients, diagnosis was made based on clinical suspicion and minimal investigations such as abdominal ultrasound, urethrocystoscopy and/or urethrocystography. The outcome was good in most patients and mortality was recorded in only 2 (2.3%) patients who had concomitant spinal and burns injuries.

Prompt management instituted on clinical suspicion of injuries presents a good outcome in patients in a limited resource setting.