Genitourinary injuries after traffic accidents: Analysis of a registry of 162,690 victims.

BACKGROUND: Traffic accidents are the most frequent cause of genitourinary injuries (GUI). Kidney injuries after trauma have been well described. However, there exists a paucity of data on other traumatic GUI after traffic accidents. The objective of this study was to analyze the frequency and type of all GUI, by user category, after traffic accidents. METHODS: Patient cases were extracted from the trauma registry of the French department of Rhone from 1996 to 2013. We assessed the urogenital injuries presented by each of road user's categories. Severity injuries were coded with the Abbreviated Injury Scale and the Injury Severity Score. Kidney trauma was mapped with the classification of the American Association for the Surgery of Trauma. Multivariate prediction models were used for analysis of data. RESULTS: Of 162,690 victims, 963 presented with GUI (0.59%). 47% were motorcyclists, 22% were in a car, 18% on bicycles, and 9% were pedestrians. The most common organ injury was kidney (41%) followed by testicular (23%). Among the 208 motorists with a GUI, kidney (70%), bladder (10%), and adrenal gland (9%) were the most frequent lesions. Among the 453 motorcyclist victims with GUI, kidney (35%) and testicular (38%) traumas were the most frequent and 62% of injuries involved external genitalia. There were 175 cyclists with GUI, 70% of injuries involved external genitalia; penile traumas (23%) were the most frequent. In total, there were 395 kidney injuries, most being low grade. According to the American Association for the Surgery of Trauma kidney injuries were grade I, 59%; grade II, 11%; grade III, 16%; grade IV, 9%; grade V, 3%; and indeterminate, 2%. CONCLUSION: GUI is an infrequent trauma after traffic accidents, with kidneys being the most commonly injured. Physicians must maintain a high awareness for external genitalia injuries in motorcyclists and cyclists. LEVEL OF EVIDENCE: Prognostic and epidemiologic study, level III.

[Types and mechanisms of 54 cases of kidney trauma in car drivers injured by road accident]. / Nature et mécanismes de 54 traumatismes du rein chez des automobilistes victimes d'accidents de la circulation.

PURPOSE: To analyse the types, mechanisms and severity of kidney trauma in injured car drivers and the effects of the presence or absence of the safety belt on the renal lesions observed. MATERIAL AND METHODS: 64,325 road accident victims were reported between 1996 and 2002. Data collection was performed in 96 primary care departments, 160 inpatient departments and 11 convalescence centres. Among the 33,431 injured car drivers, 54 presented kidney trauma (0.16%). The AAST classification was used to analyse these cases of RESULTS: The 54 cases of kidney trauma was classified as grade I and II in 39 cases, grade III in 6 cases, grade IV in 5 case, and grade V in 4 cases. Nine patients died with a kidney lesion. This lesion was never isolated, as it was associated with rupture of the spleen in 8 cases, head injury in 6 cases and chest injury in 4 cases. The mechanism of these fatal accidents was a head-on collision in every case. CONCLUSION: Kidney trauma in the car drivers of our series was rare (0.160%) and benign (72% of grade I and II lesions). Patients with a kidney lesion who died always presented multiple injuries. Renal pedicle lesions are usually observed in car drivers not wearing a

The epidemiology of trauma of the genitourinary system after traffic accidents: analysis of a register of over 43,000 victims.

OBJECTIVE: To analyse the frequency and type of injury to the genitourinary system, by user category, after traffic accidents. PATIENTS AND METHODS: The register which forms the basis of this study is unique in Europe and includes 43,056 victims of road traffic accidents, and was compiled between 1996 and 2001. The categories of road users included: motorists, motorcyclists, cyclists, pedestrians, van and bus users, and roller skaters. The urological complication rate was analysed for each category. RESULTS: In all, 199 cases of trauma of the genitourinary system (0.46%) were recorded. The most frequent urological complications were renal (43%) and testicular trauma (24%), the former most frequent in motorists (65%) and pedestrians (29%), and the latter in motorcyclists (41%). CONCLUSIONS: An analysis of this register provides better knowledge of the urogenital injuries after traffic accidents. Renal and testicular injuries are the most frequent.