206 PELVIC FRACTURES AND ASSOCIATED GENITOURINARY INJURIES DURING OPERATION IRAQI FREEDOM AND OPERATION ENDURING FREEDOM

Abstract

You have accessJournal of UrologyTrauma/Reconstruction: Trauma & Reconstructive Surgery1 Apr 2011206 PELVIC FRACTURES AND ASSOCIATED GENITOURINARY INJURIES DURING OPERATION IRAQI FREEDOM AND OPERATION ENDURING FREEDOM Hsiang Chi Cathy McLaughlin, Daniel Stinner, Jack Walter, and Joseph Hsu Hsiang Chi Cathy McLaughlinHsiang Chi Cathy McLaughlin San Antonio, TX More articles by this author , Daniel StinnerDaniel Stinner San Antonio, TX More articles by this author , Jack WalterJack Walter San Antonio, TX More articles by this author , and Joseph HsuJoseph Hsu San Antonio, TX More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2011.02.2614AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES As combat operations medical evacuation improves, urologists are encountering more devastating injuries that were previously not survivable. These injuries frequently involve pelvic fractures and lower urinary tract injuries not encountered in civilian medical centers. With continued improvements in battlefield medical care, we anticipate seeing more severe injuries. We investigated the lower urinary tract injuries associated with pelvic fractures in fatalities. We also delineated the association between specific genitourinary injuries and pelvic fracture type. METHODS A data base of all United States service members fatally injured in Operation Enduring Freedom and Operation Iraqi Freedom was queried. In 2008, 91 deceased service members sustained a pelvic fracture. Autopsies were performed on each service member documenting type of pelvic fracture, injury mechanism, associated genitourinary injuries, and other injuries. RESULTS Complete data was available for all service members. Pelvic fractures were categorized by the Tile classification. The majority of bladder, testicular, and penile injuries were associated with Tile C pelvic fracture (70%, 69%, and 66% respectively). Penetrating trauma and blunt trauma accounted for 66 %( 60 subjects) and 34% (31 subjects) respectively. Overall, concomitant bladder injury occurred in 24% of patients, testicular injury in 27%, penile injury in 6%, and prostatic injury in 6%. The majority (77% bladder, 80% testicular, 66% penile, 83% prostate) of concomitant genitourinary injuries were associated with penetrating trauma. CONCLUSIONS Significant genitourinary trauma occurs in current combat operations. The injuries sustained are unique due to their severity. The higher incidence of bladder injury associated with pelvic fracture is likely due to the mechanism and severity of injury. Additionally, wounds that may have previously been fatal are now survivable as medical evacuation improves. We describe the currently fatal genitourinary injuries that our service members sustain to make known what injuries we may encounter and have to manage in the future. © 2011 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 185Issue 4SApril 2011Page: e85 Advertisement Copyright & Permissions© 2011 by American Urological Association Education and Research, Inc.MetricsAuthor Information Hsiang Chi Cathy McLaughlin San Antonio, TX More articles by this author Daniel Stinner San Antonio, TX More articles by this author Jack Walter San Antonio, TX More articles by this author Joseph Hsu San Antonio, TX More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...