[Urogenital Injury in Polytrauma Patients: a Five-year Epidemiological Study]

Area of Science:

• Trauma Surgery
• Urology
• Emergency Medicine

Background:

• Polytrauma patients frequently sustain associated urinary tract injuries (urotrauma).
• Understanding the patterns and management of urotrauma in polytrauma is crucial for patient outcomes.

Purpose of the Study:

• To evaluate the frequency, injury mechanisms, and treatment methods for urinary tract injuries in polytrauma patients.
• To assess the outcomes of different management strategies for urotrauma.

Main Methods:

• Retrospective analysis of 231 polytrauma patients treated between 2012 and 2016.
• Classification of renal, ureteral, bladder, and urethral trauma using the American Association for the Surgery of Trauma (AAST) scale.
• Review of treatment modalities including non-operative and surgical interventions.

Main Results:

• 20.3% of polytrauma patients had urotrauma, with kidney injuries being most common.
• Non-operative management was successful for low-grade (I-II) kidney and bladder injuries.
• Surgical intervention was required for high-grade (III+) renal and bladder injuries, with complications in 39% of operative cases.
• Mortality was 14.9%, but urotrauma was not the direct cause of death.

Conclusions:

• Computed tomography with intravenous urography (CT IVU) and urography (UCG) are adequate for diagnosing urotrauma in polytrauma.
• Non-operative management is increasingly favored for renal trauma.
• Urinary tract injuries are rarely the primary cause of death in polytrauma patients.