https://imcjms.com Ibrahim Medical College Journal of Medical Science https://imcjms.com/registration/journal_full_text/386 Fri, 06 Aug 2021 23:38:48 +0000 Abstract Background and objective: Genitourinary injuries are commonly encountered in the emergency department but may be over looked in case of multi-trauma. Determining the clinical features of genitourinary injuries will help physicians in the management of genitourinary trauma. Methods: The study was conducted in a tertiary hospital. Patients of all ages, admitted in the emergency department, with trauma between 2015 and 2020 were included and analyzed. The cause of genitourinary trauma, affected organs, any accompanying injury, treatments, mortality status, and laboratory tests related to mortality were obtained from the hospital records and analyzed. Results: During the study period, 87 patients admitted to the emergency department with genitourinary trauma were included in the study. The majority of these patients (n=79) were male. Of the patients, 9.2% died. All the patients in the mortality group had additional injuries. The most frequently injured organ was determined as the kidney (51.7%), followed by the scrotum (25.3%) and penis (8.1%). Additional injuries were observed in 81.6% of the patients. Intra-abdominal organ injuries (19.5%) were the most common accompanying injuries. White blood cell count (WBC), aspartate aminotransferase (AST), alanine aminotransferase ( ALT), blood glucose and creatinine values ​​measured at the time of admission to the emergency department were found to be higher in the non-survivor group. The majority of the patients (81%) were discharged with conservative treatment and follow-up. Conclusion: It was determined that genitourinary injuries were frequently seen with additional injuries. Genitourinary injury should be evaluated carefully, especially in the presence of intra-abdominal organ injuries. IMC J Med Sci 2021; 15(2): 005. DOI: https://doi.org/10.3329/imcjms.v15i2.55807 *Correspondence: Erdal Yavuz, MD, Department of Emergency Medicine, Adıyaman University, 02200, Adıyaman, Turkey. Email: erdal_yavuz15@hotmail.com   Introduction Traumas constitute a general public health problem and an important cause of mortality and morbidity. Genitourinary injuries occur in approximately 10-20% of multi-trauma cases and are more common in young men. They usually occur with other life-threatening injuries that require immediate intervention [1]. The most common causes of genitourinary injuries are traffic accidents, falls, sexual assaults, gunshot wounds, and penetrating stab wounds. Pelvic fractures and abdominal organ damage are the most common injuries accompanied by genitourinary injuries. The most frequently injured organ in genitourinary injuries is the kidney [2]. Evaluation of genital organ damage in trauma patients is performed in a secondary examination. Genitourinary injuries can sometimes be asymptomatic or of secondary importance in case of multi-trauma. Although the mortality rate is low in genitourinary trauma, they are important in terms of their possibility to cause sexual dysfunction and permanent kidney damage. Early diagnosis and treatment of genitourinary injuries are important in preventing or minimizing complications, such as mortality and renal dysfunction, urinary incontinence and sexual dysfunction [3]. As in all trauma cases, in patients with genitourinary injuries, the airway should be protected first, and then external bleeding and hemodynamic shock should be controlled. After evaluating possible causes of fatal trauma, a genitourinary evaluation should be performed in the early period [4]. Thereore, the main purpose of this study was to evaluate genitourinary injuries in trauma patients, discuss them in light of the literature, and draw the attention of emergency physicians to these injuries.   Methods Study design and study population: The study was initiated after obtaining approval from the Clinical Research Ethics Committee of Adiyaman university (ethics committee number: 2020/07-34). Informed consent was waived due to the retrospective nature of the study. In this study, patients from all age groups who presented to our emergency department due to trauma between 2015 and 2020 were examined. Patients with injuries caused by traffic accidents, falls, battery, and sports activities were identified from the hospital archive. The epicrisis reports of these patients were examined, and the patients with genitourinary trauma were recorded. The patients’ age, gender, cause of trauma, time of trauma, injured organ, accompanying additional injury, conclusion time of consultation, length of hospital stay, clinical outcomes, and the values of laboratory investigations/tests at the time of admission to the emergency department were recorded in prepared forms. The obtained values ​​were analyzed and compared between the non-survivor and survivor groups . Patients without genitourinary trauma and those with missing data in the hospital archive were not included in the study. Statistical Analysis: SPSS software package version 17 was used in the study. The suitability of continuous data to normal distribution was investigated with the Kolmogorov-Smirnov test. Data conforming to normal distribution were analyzed using Student’s t-test, and those that were not normally distributed were analyzed with the Mann-Whitney U test. The chi-square test was used to compare qualitative data. Numerical data conforming to normal distribution were shown as mean ± standard deviation, and those that were not normally distributed were presented as median (minimum-maximum) values. Categorical variables were expressed as numbers and percentages. P values of <0.05 were considered statistically significant.   Results During the study period, a total of 87 patients, 79 (90.8 %) male and 8 (9.2%) female, presented to the emergency department with genitourinary injuries (Table-1). Concerning age, 36.7% of the patients consisted of young males aged 21-40 years. The injuries most frequently occurred in the time zone between 16:00 and 23:59 (49.4%), and when the trauma type was considered, it was most frequently related to traffic accidents (48.3%). 2026 Ibrahim Medical College. All rights reserved.