Current Management of Extraperitoneal Bladder Injuries: Results from the Multi-Institutional Genito-Urinary Trauma...

Area of Science:

• Trauma Surgery
• Urology
• Surgical Management

Background:

• Extraperitoneal bladder injuries are a subset of bladder trauma.
• Management strategies vary, including operative repair and catheter drainage.
• Understanding complication rates is crucial for optimal patient outcomes.

Purpose of the Study:

• To evaluate current management trends for extraperitoneal bladder injuries.
• To compare operative repair versus catheter drainage for these injuries.
• To identify associated complications and predictors.

Main Methods:

• Prospective data collection from 20 level 1 trauma centers (2013-2018).
• Inclusion of patients with extraperitoneal bladder injury, excluding intraperitoneal injuries and early mortality.
• Comparison of complication rates between catheter drainage and operative repair groups, with regression analysis for predictors.

Main Results:

• 157 patients with extraperitoneal bladder injuries were analyzed.
• 43% of patients underwent initial operative repair.
• No significant difference in complications between catheter drainage (23%) and operative repair (19%) groups (p=0.55).
• Bladder neck or urethral injury was the only significant predictor of complications (RR 2.69).

Conclusions:

• Operative repair was utilized in 43% of initial management cases for extraperitoneal bladder injuries.
• No significant difference in complication rates was observed between catheter drainage and operative repair.
• Concomitant urethral or bladder neck injury is the primary predictor of complications.