Bicycle-related genitourinary injuries

To use the National Trauma Data Bank (NTDB) to evaluate bicycling-related genitourinary (GU) injury. Bicycling is a popular recreational and competitive sport with recognized risks. GU injuries associated with bicycling is unknown.

Patient cases were extracted from the NTDB, version 9.1, using the mechanism of injury Ecode for pedal cyclist and ICD-9 codes for GU injuries. The type of GU injuries, patient demographics, Injury Severity Score, surgical management, outcomes, and disposition were analyzed.

Of 635,013 trauma cases evaluated, 16,585 were identified as trauma because of bicycle injury. GU injuries were sustained in 358 (2%) patients; 86% were male, with a mean age of 29 years. The most commonly injured GU organ was the kidney (75%), followed by bladder and urethra (15%), and penis and scrotum (10%). These injuries resulted in nephrectomy (0.4%), cystorrhaphy (11.3%), scrotorrhaphy (42.1%), testicular repair (3.1%), and penile repair (7.5%). Most common associated injuries included vertebral fracture (35%), pelvic fracture (25%), spleen (19%), and open head wound (15%). Patients who sustained a vertebral fracture commonly sustained a concomitant bladder and urethra (37.7%) or a renal injury (22.6%).

GU injury is an infrequent occurrence with bicycle trauma, occurring in 2% of bicycle injuries, with kidneys being the most commonly injured GU organ. Physicians treating bicyclists who sustained a vertebral fracture should be aware of a possible concomitant renal or bladder injury. Young males appear to be principally at risk for GU injury.