Pediatric Genitourinary Trauma

Pediatric genitourinary trauma constitutes a significant proportion of childhood trauma, with unique anatomical and clinical considerations. While conservative management has become standard for stable patients in pediatric solid organ injuries, data regarding the management of genitourinary trauma in children is sparse. This study aims to characterize the spectrum, treatment strategies, and outcomes of pediatric genitourinary trauma in a tertiary care center in India.

A prospective observational study was conducted between August 2018 and March 2022. Children under 12 years with documented genitourinary trauma were enrolled. Exclusion criteria included thermal injuries. Demographic details, clinical, radiological, and operative data, and their outcomes were recorded. Injuries were graded as per the American Association for the Surgery of Trauma criteria. Outcomes were monitored over 3 years. Statistical analysis was performed using Epi Info™ 7.2.2.2.

Out of 62 admitted patients of trauma, 30 patients were included in the study (M: F = 4:1) with a mean age of presentation of 6.5 years. Different modes of injury were fall from height, road traffic accidents, and other causes included sexual assaults and post-circumcision complications. Renal trauma was the most common type, primarily Grade IV injuries. Bladder trauma ranged from Grade I-V. Conservative treatment was effective in 74% of cases. Operative interventions were performed in eight patients. Complications occurred in 26%, predominantly among higher-grade injuries. However, statistical analysis revealed no significant correlation between injury grade and outcomes (P = 0.15).

Pediatric genitourinary trauma, though infrequent, often results in favorable outcomes even in high-grade injuries. Grade of injury does not correlate with the outcome in high-grade injuries in stable children.