Pattern of Lower Urinary Tract Injuries and Outcome of Their Management

Abstract

Background: Lower urinary tract injuries, though relatively uncommon, are significant complications of blunt abdominal and pelvic trauma. This study aims to analyze the pattern, and outcomes of lower urinary tract injuries in trauma patients admitted to a tertiary care center. Methods & Materials: This descriptive type of observational study was conducted at the casualty block and urology department of Dhaka Medical College Hospital, from November 2015 to November 2016. Patients of all age groups with lower abdominal & perineal injuries presented to the casualty block of Dhaka Medical College Hospital were considered as the study population. All the cases of lower abdominal & perineal injury (240 cases) and lower urinary tract injury (98 cases) during the study period were recorded to estimate the incidence of lower urinary tract injury. Data analysis was done with the SPSS 23.0 version. Result: Out of 915 trauma patients, 98 (10.71%) had lower urinary tract injuries, mostly urethral (71.43%) and predominantly in males (86.73%) aged 21–30. Initial care involved catheterization or suprapubic cystostomy, with some delays in definitive treatment. At one month, 31.6% had no complications; by three months, 63% were symptom-free. Persistent issues included poor flow and dysuria. All three deaths occurred in polytrauma cases. Conclusion: Urethral injuries (71.43%) were more common than bladder injuries (28.57%). At one month post-treatment, 31.6% had no complications, improving to 63% by three months. Some patients continued to experience urinary issues. Mortality was limited to cases with polytrauma, highlighting the need for timely, specialized care.