A prospective analysis of 33 genitourinary injuries.

Abstract

Background:Genitourinary injuries (GUIs) are usually rare but can sometimes be life threatening and are prone to functional, cosmetic and social sequelae. The aim of this study was to document the characteristics of such injuries (especially aetiology and presentation), and also our experience with managing them, in an environment with paucity of data on such.

Methodology:This was a 17-month prospective study of consecutive genitourinary injuries seen at the Jos University Teaching Hospital.

Result:A total of 33 injuries were seen in 27 patients aged 2 weeks to 70 years (mean 32.5 years) with a male to female ratio of 5.8:1. About half (44.5%) of the patients presented in the first 24 hours. The most common features were blood at the external urethral meatus (9), perineal/ pelvic pain (8), haematuria (6) and genital swelling (6). Genitourinary organs injured were the urethra in 15(45.5%), penis 7(21.2%), scrotum 4 (12.1%), bladder 3(9.1%), ureter 3(9.1%), testis 1(3.0%). Aetiology was iatrogenic (8), road traffic accidents (7), industrial accidents (3), assault (3), collapsed building (2), falls (2) and self-inflicted injuries (2). The musculoskeletal system was involved in 71.4% of patients. Suprapubic cystostomy for urethral injury was performed in 11 patients, suturing of lacerations of the scrotum, penis or testis in 8. Two patients had ureteroneocystostomy for distal ureteric injuries and simple bladder repair was done in three patients. Wound infection seen in 27.8% was the most common complication. There was a mortality rate of 7.4 %( n=2).

Conclusion: Blood at the external urethral meatus remains a useful indicator of GUIs and the urethra remains the most commonly injured organ in the genitourinary system. Attention to safety measures that will reduce the prevalence and severity of the injuries, and prompt treatment is desired to reduce morbidity and mortality


Keywords: Genitourinary, Injuries, Prospectiv

Highland Medical Research Journal Vol. 5 (1) 2007 pp. 82-89