Aim: Urogenital traumas constitute 10% of all traumas. The majority of these traumas are lower urinary tract injuries. In this article, we aimed to share our experiences of lower urinary tract injuries.
Materials and Methods: Lower urinary tract injuries admitted to the emergency department between 23 March 2011 and 1 April 2016 were retrospectively analyzed.
Results: It was observed that a total of 52 patients, 14 bladder, 38 urethra and penile injuries, were admitted to the emergency clinic between the specified dates. 10 of the 14 patients with bladder injury were male and four were female. While all patients with urethra and penile injuries were male, 24 patients had urethra, 16 patients had cavernosum injuries, two of which had cavernosum and urethra association. Penile fracture developed due to sexual intercourse in 12 of the patients with cavernosum injuries. It was observed in two of them that penile fracture developed after falling.
Conclusion: Considering the possibility of lower urinary tract and penile injuries, care should be taken in patients admitted to the emergency department due to trauma.
1. Schneider RE. Genitourinary trauma. Emerg Med Clin North Am, 1993:11(1):137-145.
2. Phillips B, Holzmer S, Turco L, Mirzaie M, Mause E, Mause A et al. Trauma to the bladder and ureter: a review of diagnosis, management, and prognosis. European Journal of Trauma and Emergency Surgery,2017: 43(6); 763-773.
3. Büyükcam F, Şen J, Akpınar Ş, Zengin Y, Çalık M, Odabaş Ö. Acil servise başvuran travmalarda ürogenital yaralanmaların değerlendirilmesi. Ulusal Travma ve Acil Cerrahi Dergisi, 2012:18(2);133-140.
4. Carroll PR, McAninch JW. Major bladder trauma: mechanisms of injury and a unified method of diagnosis and repair. J Urol, 1984:132(2);254-257. doi: 10.1016/s0022-5347(17)49581-4
5. Kaya C, Koca O, Kalkan S, Öztürk, M. Klinikte tedavi edilen ürogenital travma hastalarının değerlendirilmesi. Turkish Journal of Trauma & Emergency Surgery, 2009: 15(1); 67-70.
6. Pereira B, De Campos C, Calderan T, Reis L, Fraga G. Bladder injuries after external trauma: 20 years experience report in a population-based cross-sectional view. World journal of urology,2013: 31(4);913-917.
7. Pavelka T, Houcek P, Hora M, Hlavacova J, Linhart M. Urogenital trauma associated with pelvic ring fractures. Acta chirurgiae orthopaedicae et traumatologiae Cechoslovaca,2010: 77(1); 18.
8. Elkbuli A, Ehrhardt J, Hai S, McKenney M, Boneva D. Management of blunt intraperitoneal bladder rupture: Case report and literature review. International journal of surgery case reports,2019: 55; 160-163.
9. Lückhoff C, Mitra B, Cameron P, Fitzgerald M, Royce P. (2011). The diagnosis of acute urethral trauma. Injury, 2011: 42(9); 913-916.
10. Phillips E, Esposito A, Munarriz R. Acute penile trauma and associated morbidity: 9‐year experience at a tertiary care center. Andrology,2015: 3(3); 632-636.
11. Onuk Ö, Çilesiz N, Özkan A, Hazar A, Arslan B, Gezmiş C et al. Penil fraktür ve neden olduğu üretral yaralanmaya yaklaşımımız; 10 yıllık cerrahi deneyim. Androloji Bülteni,2017: 19(3); 69-73.
12. Elkbuli A, Ehrhardt J, Hai S, McKenney M, Boneva D. Management of blunt intraperitoneal bladder rupture: Case report and literature review. International journal of surgery case reports, 2019: 55; 160-163.
13. Gedik A, Gedik E, Tutuş A, Kayan D, Bircan, K. Künt ve penetran mesane yaralanmaları. Turkish Journal of Urology, 2020: 36(1).
14. Fouladi D, Shayesteh S, Fishman E, Chu, L. Imaging of urinary bladder injury: the role of CT cystography. Emergency radiology, 2020: 27(1); 87-95.
15. Phillips B, Holzmer S, Turco L, Mirzaie M, Mause E, Mause A et al . Trauma to the bladder and ureter: a review of diagnosis, management, and prognosis. European Journal of Trauma and Emergency Surgery,2017: 43(6); 763-773.
16. Shenfeld O, Gnessin E. Management of urogenital trauma: state of the art. Current opinion in urology,2011: 21(6); 449-454.
17. Yeung L, McDonald A, Como J, Robinson B, Knight, J, Person M et al . Management of blunt force bladder injuries: A practice management guideline from the Eastern Association for the Surgery of Trauma. Journal of Trauma and Acute Care Surgery,2019: 86(2);326-336.
18. Lazzeri M, Sansalone S, Guazzoni G, Barbagli G.Incidence, causes, and complications of urethral stricture disease. European Urology Supplements,2016: 15(1); 2-6.
19. Dane B, Baxter A, Bernstein MP. Imaging genitourinary trauma. Radiologic Clinics,2017: 55(2); 321-335.
20. Devine CJ Jr, Devine PC, Horton CE. Anterior urethral injury: etiology, diagnosis, and initial management. Urol Clin North Am,1977 Feb:4(1);125-31.
21. Battaloglu E, Figuero M, Moran C, Lecky F, Porter K. Urethral injury in major trauma. Injury,2019: 50(5);1053-1057.
22. Deniz M, Ergün A, Umut Ü, Çelik O, Evliyaoğlu Y, Gürbüz Z, Erçil H. Penil fraktür: Dört yıllık klinik deneyimimiz. Yeni Üroloji Dergisi, 2017; 11(3): 16-19.
23. Amer T, Wilson R, Chlosta P, AlBuheissi S, Qazi H, Fraser M, et al. Penile fracture: a meta-analysis. Urologia internationalis,2016: 96(3); 315-329.
24. Muentener M, Suter S, Hauri D, Sulser T. Long-term experience with surgical and conservative treatment of penile fracture. The Journal of urology, 2004: 172(2); 576-579.
25. Ceylan, K, Yılmaz Y, Yıldız A, Gönülalan H . Penil Fraktür. Van Tıp Dergisi, 2005; 12(3):206-208.
Alt Üriner Sistem ve Penis Travmaları Deneyimlerimiz
Amaç: Ürogenital travmalar tüm travmaların %10’unu oluşturmaktadır. Bu travmaların önemli bir kısmını ise alt üriner sistem yaralanmaları oluşturmaktadır. Bu makalede alt üriner sistem yaralanmaları ile ilgili deneyimlerimizin paylaşılması amaçlandı.
Gereç ve Yöntemler: 23 Mart 2011 ile 1 Nisan 2016 tarihleri arasında acil polikliniğine başvuran alt üriner sistem ve penis yaralanmaları hastalarının dosyaları retrospektif olarak hastanemiz otomasyon sistemi taranarak incelendi. Hastalar demografik özellikler, etyoloji, eşlik eden yaralanma ve cerrahi sonuçları açısından değerlendirildi.
Bulgular: Belirtilen tarihler arasında acil polikliniğine 14 mesane, 38 üretra ve penis yaralanması olmak üzere toplam 52 hastanın başvurduğu görüldü. Mesane yaralanması olan 14 hastanın 10’u erkek iken dördü kadın idi. Üretra ve penis yaralanması olan tüm hastalar erkek iken bu hastaların 22’sinde üretra 14’ünde penis yaralanması, ikisinde ise hem penis hem üretra yaralanması mevcut idi. Kavernozum yaralanması olan hastaların 12’sinde cinsel ilişki nedeniyle penil fraktür gelişmişti. İkisinde ise düşme sonra penil fraktür gelişmiş olduğu görüldü.
Sonuç: Acil servise travma nedeniyle başvuran hastalarda alt üriner sistem ve penis yaralanmaları da olabileceği göz önünde bulundurularak dikkatli olunmalıdır.
1. Schneider RE. Genitourinary trauma. Emerg Med Clin North Am, 1993:11(1):137-145.
2. Phillips B, Holzmer S, Turco L, Mirzaie M, Mause E, Mause A et al. Trauma to the bladder and ureter: a review of diagnosis, management, and prognosis. European Journal of Trauma and Emergency Surgery,2017: 43(6); 763-773.
3. Büyükcam F, Şen J, Akpınar Ş, Zengin Y, Çalık M, Odabaş Ö. Acil servise başvuran travmalarda ürogenital yaralanmaların değerlendirilmesi. Ulusal Travma ve Acil Cerrahi Dergisi, 2012:18(2);133-140.
4. Carroll PR, McAninch JW. Major bladder trauma: mechanisms of injury and a unified method of diagnosis and repair. J Urol, 1984:132(2);254-257. doi: 10.1016/s0022-5347(17)49581-4
5. Kaya C, Koca O, Kalkan S, Öztürk, M. Klinikte tedavi edilen ürogenital travma hastalarının değerlendirilmesi. Turkish Journal of Trauma & Emergency Surgery, 2009: 15(1); 67-70.
6. Pereira B, De Campos C, Calderan T, Reis L, Fraga G. Bladder injuries after external trauma: 20 years experience report in a population-based cross-sectional view. World journal of urology,2013: 31(4);913-917.
7. Pavelka T, Houcek P, Hora M, Hlavacova J, Linhart M. Urogenital trauma associated with pelvic ring fractures. Acta chirurgiae orthopaedicae et traumatologiae Cechoslovaca,2010: 77(1); 18.
8. Elkbuli A, Ehrhardt J, Hai S, McKenney M, Boneva D. Management of blunt intraperitoneal bladder rupture: Case report and literature review. International journal of surgery case reports,2019: 55; 160-163.
9. Lückhoff C, Mitra B, Cameron P, Fitzgerald M, Royce P. (2011). The diagnosis of acute urethral trauma. Injury, 2011: 42(9); 913-916.
10. Phillips E, Esposito A, Munarriz R. Acute penile trauma and associated morbidity: 9‐year experience at a tertiary care center. Andrology,2015: 3(3); 632-636.
11. Onuk Ö, Çilesiz N, Özkan A, Hazar A, Arslan B, Gezmiş C et al. Penil fraktür ve neden olduğu üretral yaralanmaya yaklaşımımız; 10 yıllık cerrahi deneyim. Androloji Bülteni,2017: 19(3); 69-73.
12. Elkbuli A, Ehrhardt J, Hai S, McKenney M, Boneva D. Management of blunt intraperitoneal bladder rupture: Case report and literature review. International journal of surgery case reports, 2019: 55; 160-163.
13. Gedik A, Gedik E, Tutuş A, Kayan D, Bircan, K. Künt ve penetran mesane yaralanmaları. Turkish Journal of Urology, 2020: 36(1).
14. Fouladi D, Shayesteh S, Fishman E, Chu, L. Imaging of urinary bladder injury: the role of CT cystography. Emergency radiology, 2020: 27(1); 87-95.
15. Phillips B, Holzmer S, Turco L, Mirzaie M, Mause E, Mause A et al . Trauma to the bladder and ureter: a review of diagnosis, management, and prognosis. European Journal of Trauma and Emergency Surgery,2017: 43(6); 763-773.
16. Shenfeld O, Gnessin E. Management of urogenital trauma: state of the art. Current opinion in urology,2011: 21(6); 449-454.
17. Yeung L, McDonald A, Como J, Robinson B, Knight, J, Person M et al . Management of blunt force bladder injuries: A practice management guideline from the Eastern Association for the Surgery of Trauma. Journal of Trauma and Acute Care Surgery,2019: 86(2);326-336.
18. Lazzeri M, Sansalone S, Guazzoni G, Barbagli G.Incidence, causes, and complications of urethral stricture disease. European Urology Supplements,2016: 15(1); 2-6.
19. Dane B, Baxter A, Bernstein MP. Imaging genitourinary trauma. Radiologic Clinics,2017: 55(2); 321-335.
20. Devine CJ Jr, Devine PC, Horton CE. Anterior urethral injury: etiology, diagnosis, and initial management. Urol Clin North Am,1977 Feb:4(1);125-31.
21. Battaloglu E, Figuero M, Moran C, Lecky F, Porter K. Urethral injury in major trauma. Injury,2019: 50(5);1053-1057.
22. Deniz M, Ergün A, Umut Ü, Çelik O, Evliyaoğlu Y, Gürbüz Z, Erçil H. Penil fraktür: Dört yıllık klinik deneyimimiz. Yeni Üroloji Dergisi, 2017; 11(3): 16-19.
23. Amer T, Wilson R, Chlosta P, AlBuheissi S, Qazi H, Fraser M, et al. Penile fracture: a meta-analysis. Urologia internationalis,2016: 96(3); 315-329.
24. Muentener M, Suter S, Hauri D, Sulser T. Long-term experience with surgical and conservative treatment of penile fracture. The Journal of urology, 2004: 172(2); 576-579.
25. Ceylan, K, Yılmaz Y, Yıldız A, Gönülalan H . Penil Fraktür. Van Tıp Dergisi, 2005; 12(3):206-208.
Demir, M., Eryılmaz, R., Taken, K., Araz, Ş. (2021). Alt Üriner Sistem ve Penis Travmaları Deneyimlerimiz. Balıkesir Medical Journal, 5(1), 29-35. https://doi.org/10.33716/bmedj.858133