MP3-04 OUTCOME OF PRIMARY URETHRAL REALIGNMENT IN THE MANAGEMENT OF POSTERIOR URETHRAL DISRUPTION

Abstract

METHODS: We retrospectively reviewed patients’ records with renal trauma that were treated at adult level 1 trauma centers in Utah from January 2005 to January 2011. Data on patient demographics, injury characteristics, management, and outcomes was collected. All available radiological imaging was independently reviewed and renal injury was graded with the AAST organ injury scale. RESULTS: 138 patients were identified as having an AAST III-V renal injury. 30% (42 of 138) of renal injuries were sustained during sporting activities. The most common sports-related injuries were skiing and snowboarding in 26 (62%), being struck by another person or collision with stationary object in 10 (24%), and biking in 3 (7%). Mean AAST renal grade was 3.5 (SD 0.55) for sports and 3.7 (SD 0.78) for non-sports (p1⁄40.08). Male gender was over-represented amongst all renal injuries, but more so in sports related injuries (90.5% vs 61%, p<0.001). Mean injury severity scores (ISS) were 12.6 and 27.3 for sports and non-sports related trauma (p<0.001). Sports related trauma was more likely to be isolated without other solid abdominal organ injury, 78% vs 36% (p<0.001). Signs of hemodynamic instability (hypotension or tachycardia) were present in 47.6% and 67% of patients with sports and non-sports renal trauma (p1⁄40.037). 11.9% of sports injuries required intervention compared with 20% of non-sports injuries (p1⁄40.332). CONCLUSIONS: In a statewide trauma database, snow sports were the most common cause of high-grade sports related renal injuries. Sports associated renal trauma is more likely to occur in isolation without other abdominal solid organ injuries and without hemodynamic instability. Treating clinicians need to be aware that these injuries can present without the usual sequela associated with polytrauma.