Urological injury and assessment in patients with fractured pelvis

Of 200 patients with pelvic fractures 32 (25 male and 7 female patients) had urological injury. Of these 32 patients 31 had pubic ramus or symphyseal fractures: 29 had gross hematuria and a urine specimen was not obtained in 2. Only 1 of 77 patients with microscopic hematuria had serious urological injury. We believe that excretory urography is not necessary in all cases of pelvic fracture, and that urethrography and cystography are indicated only in cases of gross hematuria or when other clinical signs indicate a high likelihood of bladder or urethral trauma.