Overview of the West German Urological Multicenter Study Traumatology

Summary

A total of 385 patients (83% men, 52% aged 16–30) with urogenital (UG) trauma were treated in 19 urological clinics between April 1984 and December 1986. In all, 41% of the accidents were due to traffic; 13% to work and sports each; 8% to sexual activities; and 6% to violence. The distribution of injury severity included 40% light, 21% moderate and 39% severe. Of 427 UG lesions, 27% were combined with intraabdominal and 24% with pelvic injuries. The kidneys were involved in 51% of cases and the bladder, urethra, penis and scrotum, including its content, in ca. 10% each. Of the renal traumas, 49% were ruptures; 48% contusions; and 7% hilar lesions,a nd in 6% the complete destruction of the organ occurred. In all, 76% of these traumas were treated conservatively, whereas 8% each required reconstruction or nephrectomy. Amongst the urethral ruptures, 46% were complete; 39% partial posterior; and 11% ruptures of the penile urethra. In 43% of cases the treatment was conservative and in 41% a primary reconstruction was carried out. All intraperitoneal (43%) and 2/3 of the extraperitoneal bladder ruptures (57%) were operated on. Gross hematuria was found in 73% of the renal, 83% of the vesical and 73% of the urethral injuries. Microhematuria occurred in 24%, 9% and 13% of cases, whereas no hematuria was found in 3%, 5% and 13% of the kidney, bladder and urethral injuries, respectively. The injury-relevant sensitivity of the imaging methods was computed to be 95% for cystograms, 91% for urethrograms and 83% for angiograms. When used to screen trauma patients, the sensitivity proved to be 69% for the CT scan, 55% for the intravenous pyelogram (IVP) and 54% for sonography. Overall, 37% of 161 complications involved the UG tract, followed by neurological complications, those due to the operation or treatment, to infections or to organ failure. In all, 11% of patients remained in the hospital for only 1 day; 50% for up to 13 days; 20% for 14–60 days; and 17% for >60 days.