Skip to main content
SpringerLink
Log in

Genitourinary Trauma in Geriatric Patients

  • Chapter
  • First Online:
Geriatric Urology

Abstract

The traumatically injured geriatric patient presents a challenge to the practitioner. Increased morbidity and mortality can result in unique requirements for the treatment of elderly patients. The principles of surgical management of genitourinary injuries remain largely unchanged in the geriatric population. Reconstructive techniques to repair these injuries generally require appropriate evaluation and timing of repair. Fortunately, the treatment of genitourinary injuries in the geriatric population remains largely successful.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
eBook
USD 16.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 119.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 169.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Similar content being viewed by others

References

  1. Sondik EJ, Madans JH, Gentleman JF. Vital and Health Statistics. Summary Health Statistics for the US Population: National Health Interview Survey, 2011 [Internet]. 2012 February 10, 2013; 10(255). Available from: http://www.cdc.gov/nchs/data/series/sr_10/sr10_255.pdf

  2. Gerberding JL, Falk H, Arias I. CDC Injury Factbook: National Center for Injury Prevention and Control, Centers for Disease Control and Prevention; 2006 [cited 2013 February 10]. Available from: http://www.cdc.gov/Injury/publications/FactBook/InjuryBook2006.pdf

  3. Life Years Lost to Unintentional Injury, 2010 [Internet]. Centers for Disease Control and Prevention; National Center for Injury Prevention and Control: Web-Based Injury Statistics Query and Reporting System (WISQARS). 2010 [cited February 10, 2013]. Available from: http://webappa.cdc.gov/sasweb/ncipc/ypll10.html

  4. 10 Leading Causes of Death by Age Group, United States-2010 [Internet]. Centers for Disease Control and Prevention; National Center for Injury Prevention and Control: Web-Based Injury Statistics Query and Reporting System (WISQARS). 2010 [cited February 10, 2013]. Available from: http://www.cdc.gov/injury/wisqars/pdf/10LCID_All_Deaths_By_Age_Group_2010-a.pdf

  5. 10 Leading Causes of Injury Deaths by Age Group Highlighting Unintentional Injury Deaths, United States - 2010 [Internet]. Centers for Disease Control and Prevention; National Center for Injury Prevention and Control: Web-Based Injury Statistics Query and Reporting System (WISQARS). 2010 [cited February 10, 2013]. Available from: http://www.cdc.gov/injury/wisqars/pdf/10LCID_Unintentional_Deaths_2010-a.pdf

  6. 10 Leading Causes of Injury Deaths by Age Group Highlighting Violence-Related Injury Deaths, United States - 2010 [Internet]. Centers for Disease Control and Prevention; National Center for Injury Prevention and Control: Web-Based Injury Statistics Query and Reporting System (WISQARS). 2010 [cited February 10, 2013]. Available from: http://www.cdc.gov/injury/wisqars/pdf/10LCID_Violence_Related_Injury_Deaths_2010-a.pdf

  7. National Estimates of the 10 Leading Causes of Nonfatal Injuries Treated in Hospital Emergency Departments, United States - 2010 [Internet]. Centers for Disease Control and Prevention; National Center for Injury Prevention and Control: Web-Based Injury Statistics Query and Reporting System (WISQARS). 2010 [cited February 10, 2013]. Available from: http://www.cdc.gov/Injury/wisqars/pdf/National_Estim_10_Leading_Causes_Nonfatal_Injuries_Tx_Hospital-ED_US2010-a.pdf

  8. Joanisse M, Gagnon S, Voloaca M. Overly cautious and dangerous: an empirical evidence of the older driver stereotypes. Accid Anal Prev. 2012;45:802–10.

    Google Scholar 

  9. Cost of Fall Injuries in Older Persons in the United States, 2005 [Internet]. Centers for Disease Control and Prevention; National Center for Injury Prevention and Control. 2011 [cited February 10, 2013]. Available from: http://www.cdc.gov/homeandrecreationalsafety/falls/data/cost-estimates.html

  10. Sleet DA, Moffett DB, Stevens J. CDC’s research portfolio in older adult fall prevention: a review of progress, 1985-2005, and future research directions. J Saf Res. 2008;39(3):259–67.

    Google Scholar 

  11. Gillespie LD, Gillespie WJ, Robertson MC, Lamb SE, Cumming RG, Rowe BH. Interventions for preventing falls in elderly people. Cochrane Database Syst Rev. 2003;4, CD000340.

    Google Scholar 

  12. Older Drivers [Internet]. Centers for Disease Control and Prevention; National Center for Injury Prevention and Control. 2011 [cited February 10, 2013]. Available from: http://www.cdc.gov/Features/OlderDrivers

  13. Mathias JL, Lucas LK. Cognitive predictors of unsafe driving in older drivers: a meta-analysis. Int Psychogeriatr IPA. 2009;21(4):637–53.

    Google Scholar 

  14. Rubin GS, Ng ES, Bandeen-Roche K, Keyl PM, Freeman EE, West SK. A prospective, population-based study of the role of visual impairment in motor vehicle crashes among older drivers: the SEE study. Investig Ophthalmol Visual Sci. 2007;48(4):1483–91.

    Google Scholar 

  15. Green KA, McGwin Jr G, Owsley C. Associations between visual, hearing, and dual sensory impairments and history of motor vehicle collision involvement of older drivers. J Am Geriatr Soc. 2013.

    Google Scholar 

  16. Ball K, Edwards JD, Ross LA, McGwin Jr G. Cognitive training decreases motor vehicle collision involvement of older drivers. J Am Geriatr Soc. 2010;58(11):2107–13.

    Google Scholar 

  17. Taylor MD, Tracy JK, Meyer W, Pasquale M, Napolitano LM. Trauma in the elderly: intensive care unit resource use and outcome. J Trauma. 2002;53(3):407–14.

    Google Scholar 

  18. Perdue PW, Watts DD, Kaufmann CR, Trask AL. Differences in mortality between elderly and younger adult trauma patients: geriatric status increases risk of delayed death. J Trauma. 1998;45(4):805–10.

    Google Scholar 

  19. Grossman MD, Miller D, Scaff DW, Arcona S. When is an elder old? Effect of preexisting conditions on mortality in geriatric trauma. J Trauma. 2002;52(2):242–6.

    Google Scholar 

  20. Tornetta 3rd P, Mostafavi H, Riina J, Turen C, Reimer B, Levine R, et al. Morbidity and mortality in elderly trauma patients. J Trauma. 1999;46(4):702–6.

    Google Scholar 

  21. Bennett KM, Scarborough JE, Vaslef S. Outcomes and health care resource utilization in super-elderly trauma patients. J Surg Res. 2010;163(1):127–31.

    Google Scholar 

  22. Meldon SW, Reilly M, Drew BL, Mancuso C, Fallon Jr W. Trauma in the very elderly: a community-based study of outcomes at trauma and nontrauma centers. J Trauma. 2002;52(1):79–84.

    Google Scholar 

  23. Rogers A, Rogers F, Bradburn E, Krasne M, Lee J, Wu D, et al. Old and undertriaged: a lethal combination. Am Surg. 2012;78(6):711–5.

    Google Scholar 

  24. Garwe T, Roberts ZV, Albrecht RM, Morgan AE, Johnson JJ, Neas BR. Direct transport of geriatric trauma patients with pelvic fractures to a Level I trauma center within an organized trauma system: impact on two-week incidence of in-hospital complications. Am J Surg. 2012;204(6):921–5, discussion 5-6.

    Google Scholar 

  25. Fallon Jr WF, Rader E, Zyzanski S, Mancuso C, Martin B, Breedlove L, et al. Geriatric outcomes are improved by a geriatric trauma consultation service. J Trauma. 2006;61(5):1040–6.

    Google Scholar 

  26. Lenartowicz M, Parkovnick M, McFarlan A, Haas B, Straus SE, Nathens AB, et al. An evaluation of a proactive geriatric trauma consultation service. Ann Surg. 2012;256(6):1098–101.

    Google Scholar 

  27. Jacobs DG. Special considerations in geriatric injury. Curr Opin Crit Care. 2003;9(6):535–9.

    Google Scholar 

  28. Wright JL, Nathens AB, Rivara FP, Wessells H. Renal and extrarenal predictors of nephrectomy from the national trauma data bank. J Urol. 2006;175(3 Pt 1):970–5, discussion 5.

    Google Scholar 

  29. Alsikafi NF, Rosenstein DI. Staging, evaluation, and nonoperative management of renal injuries. Urol Clin North Am. 2006;33(1):13–9.

    Google Scholar 

  30. Krieger JN, Algood CB, Mason JT, Copass MK, Ansell JS. Urological trauma in the Pacific Northwest: etiology, distribution, management and outcome. J Urol. 1984;132(1):70–3.

    Google Scholar 

  31. McAninch JW, Carroll PR, Klosterman PW, Dixon CM, Greenblatt MN. Renal reconstruction after injury. J Urol. 1991;145(5):932–7.

    Google Scholar 

  32. Bjurlin MA, Goble SM, Fantus RJ, Hollowell CM. Outcomes in geriatric genitourinary trauma. J Am Coll Surg. 2011;213(3):415–21.

    Google Scholar 

  33. Moore EE, Shackford SR, Pachter HL, McAninch JW, Browner BD, Champion HR, et al. Organ injury scaling: spleen, liver, and kidney. J Trauma. 1989;29(12):1664–6.

    Google Scholar 

  34. Santucci RA, McAninch JW, Safir M, Mario LA, Service S, Segal MR. Validation of the American Association for the Surgery of Trauma organ injury severity scale for the kidney. J Trauma. 2001;50(2):195–200.

    Google Scholar 

  35. Shariat SF, Roehrborn CG, Karakiewicz PI, Dhami G, Stage KH. Evidence-based validation of the predictive value of the American Association for the Surgery of Trauma kidney injury scale. J Trauma. 2007;62(4):933–9.

    Google Scholar 

  36. Buckley JC, McAninch JW. Revision of current American Association for the Surgery of Trauma Renal Injury grading system. J Trauma. 2011;70(1):35–7.

    Google Scholar 

  37. Lynch TH, Martinez-Pineiro L, Plas E, Serafetinides E, Turkeri L, Santucci RA, et al. EAU guidelines on urological trauma. Eur Urol. 2005;47(1):1–15.

    Google Scholar 

  38. McAndrew JD, Corriere Jr JN. Radiographic evaluation of renal trauma: evaluation of 1103 consecutive patients. Br J Urol. 1994;73(4):352–4.

    Google Scholar 

  39. Federle MP, Brown TR, McAninch JW. Penetrating renal trauma: CT evaluation. J Computer Assisted Tomogr. 1987;11(6):1026–30.

    Google Scholar 

  40. Alonso RC, Nacenta SB, Martinez PD, Guerrero AS, Fuentes CG. Kidney in danger: CT findings of blunt and penetrating renal trauma. Radiographics. 2009;29(7):2033–53.

    Google Scholar 

  41. Hardee MJ, Lowrance W, Brant WO, Presson AP, Stevens MH, Myers JB. High Grade Renal Injuries: Application of Parkland Hospital Predictors of Intervention for Renal Hemorrhage to a large series of patients with blunt renal trauma. J Urol. 2012;189:1771.

    Google Scholar 

  42. Charbit J, Manzanera J, Millet I, Roustan JP, Chardon P, Taourel P, et al. What are the specific computed tomography scan criteria that can predict or exclude the need for renal angioembolization after high-grade renal trauma in a conservative management strategy? J Trauma. 2011;70(5):1219–27, discussion 27-8.

    Google Scholar 

  43. Santucci RA, Fisher MB. The literature increasingly supports expectant (conservative) management of renal trauma–a systematic review. J Trauma. 2005;59(2):493–503.

    Google Scholar 

  44. Broghammer JA, Fisher MB, Santucci RA. Conservative management of renal trauma: a review. Urology. 2007;70(4):623–9.

    Google Scholar 

  45. Voelzke BB, McAninch JW. Renal gunshot wounds: clinical management and outcome. J Trauma. 2009;66(3):593–600. discussion 601.

    Google Scholar 

  46. Armenakas NA, Duckett CP, McAninch JW. Indications for nonoperative management of renal stab wounds. J Urol. 1999;161(3):768–71.

    Google Scholar 

  47. Wessells H, Suh D, Porter JR, Rivara F, MacKenzie EJ, Jurkovich GJ, et al. Renal injury and operative management in the United States: results of a population-based study. J Trauma. 2003;54(3):423–30.

    Google Scholar 

  48. Danuser H, Wille S, Zoscher G, Studer U. How to treat blunt kidney ruptures: primary open surgery or conservative treatment with deferred surgery when necessary? Eur Urol. 2001;39(1):9–14.

    Google Scholar 

  49. Hammer CC, Santucci RA. Effect of an institutional policy of nonoperative treatment of grades I to IV renal injuries. J Urol. 2003;169(5):1751–3.

    Google Scholar 

  50. Wessells H, McAninch JW. Effect of colon injury on the management of simultaneous renal trauma. J Urol. 1996;155(6):1852–6.

    Google Scholar 

  51. Rosen MA, McAninch JW. Management of combined renal and pancreatic trauma. J Urol. 1994;152(1):22–5.

    Google Scholar 

  52. Moudouni SM, Patard JJ, Manunta A, Guiraud P, Guille F, Lobel B. A conservative approach to major blunt renal lacerations with urinary extravasation and devitalized renal segments. BJU Int. 2001;87(4):290–4.

    Google Scholar 

  53. Carpio F, Morey AF. Radiographic staging of renal injuries. World J Urol. 1999;17(2):66–70.

    Google Scholar 

  54. Morey AF, McAninch JW, Tiller BK, Duckett CP, Carroll PR. Single shot intraoperative excretory urography for the immediate evaluation of renal trauma. J Urol. 1999;161(4):1088–92.

    Google Scholar 

  55. Gonzalez RP, Falimirski M, Holevar MR, Evankovich C. Surgical management of renal trauma: is vascular control necessary? J Trauma. 1999;47(6):1039–42.

    Google Scholar 

  56. Brown MF, Graham JM, Mattox KL, Feliciano DV, DeBakey ME. Renovascular trauma. Am J Surg. 1980;140(6):802–5.

    Google Scholar 

  57. Knudson MM, Harrison PB, Hoyt DB, Shatz DV, Zietlow SP, Bergstein JM, et al. Outcome after major renovascular injuries: a Western trauma association multicenter report. J Trauma. 2000;49(6):1116–22.

    Google Scholar 

  58. Master VA, McAninch JW. Operative management of renal injuries: parenchymal and vascular. Urol Clin North Am. 2006;33(1):21–31. v-vi.

    Google Scholar 

  59. Matthews LA, Smith EM, Spirnak JP. Nonoperative treatment of major blunt renal lacerations with urinary extravasation. J Urol. 1997;157(6):2056–8.

    Google Scholar 

  60. Lee DG, Lee SJ. Delayed hemorrhage from a pseudoaneurysm after blunt renal trauma. Int J Urol. 2005;12(10):909–11.

    Google Scholar 

  61. Giannopoulos A, Manousakas T, Alexopoulou E, Brountzos E, Papadoukakis S, Kelekis D. Delayed life-threatening haematuria from a renal pseudoaneurysm caused by blunt renal trauma treated with selective embolization. Urol Int. 2004;72(4):352–4.

    Google Scholar 

  62. Elliott SP, McAninch JW. Ureteral injuries from external violence: the 25-year experience at San Francisco General Hospital. J Urol. 2003;170(4 Pt 1):1213–6.

    Google Scholar 

  63. Azimuddin K, Milanesa D, Ivatury R, Porter J, Ehrenpreis M, Allman DB. Penetrating ureteric injuries. Injury. 1998;29(5):363–7.

    Google Scholar 

  64. Presti Jr JC, Carroll PR, McAninch JW. Ureteral and renal pelvic injuries from external trauma: diagnosis and management. J Trauma. 1989;29(3):370–4.

    Google Scholar 

  65. Siram SM, Gerald SZ, Greene WR, Hughes K, Oyetunji TA, Chrouser K, et al. Ureteral trauma: patterns and mechanisms of injury of an uncommon condition. Am J Surg. 2010;199(4):566–70.

    Google Scholar 

  66. Perez-Brayfield MR, Keane TE, Krishnan A, Lafontaine P, Feliciano DV, Clarke HS. Gunshot wounds to the ureter: a 40-year experience at Grady Memorial Hospital. J Urol. 2001;166(1):119–21.

    Google Scholar 

  67. Peterson NE, Pitts 3rd JC. Penetrating injuries of the ureter. J Urol. 1981;126(5):587–90.

    Google Scholar 

  68. Holden S, Hicks CC, O’Brien DP, Stone HH, Walker JA, Walton KN. Gunshot wounds of the ureter: a 15-year review of 63 consecutive cases. J Urol. 1976;116(5):562–4.

    Google Scholar 

  69. Liroff SA, Pontes JE, Pierce Jr JM. Gunshot wounds of the ureter: 5 years of experience. J Urol. 1977;118(4):551–3.

    Google Scholar 

  70. Stutzman RE. Ballistics and the management of ureteral injuries from high velocity missiles. J Urol. 1977;118(6):947–9.

    Google Scholar 

  71. Carlton Jr CE, Scott Jr R, Guthrie AG. The initial management of ureteral injuries: a report of 78 cases. J Urol. 1971;105(3):335–40.

    Google Scholar 

  72. Eikenberg H-UaA MA. Gunshot wounds to the ureter. J Trauma. 1976;16(7):562–5.

    Google Scholar 

  73. Lankford R, Block NL, Politano VA. Gunshot wounds of the ureter: a review of 10 cases. J Trauma. 1974;14(10):848–52.

    Google Scholar 

  74. Campbell Jr EW, Filderman PS, Jacobs SC. Ureteral injury due to blunt and penetrating trauma. Urology. 1992;40(3):216–20.

    Google Scholar 

  75. Rober PE, Smith JB, Pierce Jr JM. Gunshot injuries of the ureter. J Trauma. 1990;30(1):83–6.

    Google Scholar 

  76. Steers WD, Corriere Jr JN, Benson GS, Boileau MA. The use of indwelling ureteral stents in managing ureteral injuries due to external violence. J Trauma. 1985;25(10):1001–3.

    Google Scholar 

  77. Bright 3rd TC, Peters PC. Ureteral injuries due to external violence: 10 years' experience with 59 cases. J Trauma. 1977;17(8):616–20.

    Google Scholar 

  78. Ghali AM, El Malik EM, Ibrahim AI, Ismail G, Rashid M. Ureteric injuries: diagnosis, management, and outcome. J Trauma. 1999;46(1):150–8.

    Google Scholar 

  79. Palmer LS, Rosenbaum RR, Gershbaum MD, Kreutzer ER. Penetrating ureteral trauma at an urban trauma center: 10-year experience. Urology. 1999;54(1):34–6.

    Google Scholar 

  80. Bjurlin MA, Goble SM, Fantus RJ, Hollowell CM. Outcomes in geriatric genitourinary trauma. J Am Coll Surg. 2011;213(3):415–21.

    Google Scholar 

  81. Ortega SJ, Netto FS, Hamilton P, Chu P, Tien HC. CT scanning for diagnosing blunt ureteral and ureteropelvic junction injuries. BMC Urol. 2008;8:3.

    Google Scholar 

  82. Digiacomo JC, Frankel H, Rotondo MF, Schwab CW, Shaftan GW. Preoperative radiographic staging for ureteral injuries is not warranted in patients undergoing celiotomy for trauma. Am Surg. 2001;67(10):969–73.

    Google Scholar 

  83. Best CD, Petrone P, Buscarini M, Demiray S, Kuncir E, Kimbrell B, et al. Traumatic ureteral injuries: a single institution experience validating the American Association for the Surgery of Trauma-Organ Injury Scale grading scale. J Urol. 2005;173(4):1202–5.

    Google Scholar 

  84. Brandes SB, Chelsky MJ, Buckman RF, Hanno PM. Ureteral injuries from penetrating trauma. J Trauma. 1994;36(6):766–9.

    Google Scholar 

  85. Brandes S, Coburn M, Armenakas N, McAninch J. Diagnosis and management of ureteric injury: an evidence-based analysis. BJU Int. 2004;94(3):277–89.

    Google Scholar 

  86. Velmahos GC, Degiannis E, Wells M, Souter I. Penetrating ureteral injuries: the impact of associated injuries on management. Am Surg. 1996;62(6):461–8.

    Google Scholar 

  87. Scalea TM, Phillips TF, Goldstein AS, Sclafani SJ, Duncan AO, Atweh NA, et al. Injuries missed at operation: nemesis of the trauma surgeon. J Trauma. 1988;28(7):962–7.

    Google Scholar 

  88. Moreno C, Moore EE, Rosenberger A, Cleveland HC. Hemorrhage associated with major pelvic fracture: a multispecialty challenge. J Trauma. 1986;26(11):987–94.

    Google Scholar 

  89. Chang TT, Schecter WP. Injury in the elderly and end-of-life decisions. Surg Clin North Am. 2007;87(1):229–45. viii.

    Google Scholar 

  90. Alost T, Waldrop RD. Profile of geriatric pelvic fractures presenting to the emergency department. Am J Emerg Med. 1997;15(6):576–8.

    Google Scholar 

  91. Melton LJ, Sampson JM, Morrey BF, Ilstrup DM. Epidemiologic features of pelvic fractures. Clin Orthopaed Relat Res. 1981;155:43–7.

    Google Scholar 

  92. Ragnarsson B, Jacobsson B. Epidemiology of pelvic fractures in a Swedish county. Acta orthopaedica Scandinavica. 1992;63(3):297–300.

    Google Scholar 

  93. Kannus P, Palvanen M, Niemi S, Parkkari J, Jarvinen M. Epidemiology of osteoporotic pelvic fractures in elderly people in Finland: sharp increase in 1970-1997 and alarming projections for the new millennium. Osteoporosis Int. 2000;11(5):443–8.

    Google Scholar 

  94. Campbell AJ, Reinken J, Allan BC, Martinez GS. Falls in old age: a study of frequency and related clinical factors. Age Ageing. 1981;10(4):264–70.

    Google Scholar 

  95. Tinetti ME, Speechley M, Ginter SF. Risk factors for falls among elderly persons living in the community. New Engl J Med. 1988;319(26):1701–7.

    Google Scholar 

  96. Tile M. Acute pelvic fractures: I causation and classification. J Am Acad Orthopaed Surg. 1996;4(3):143–51.

    Google Scholar 

  97. Burgess AR, Eastridge BJ, Young JW, Ellison TS, Ellison Jr PS, Poka A, et al. Pelvic ring disruptions: effective classification system and treatment protocols. J Trauma. 1990;30(7):848–56.

    Google Scholar 

  98. Canale T, James B. Campbell’s operative orthopaedics. 12th ed. Philadelphia: Elsevier; 2012.

    Google Scholar 

  99. Krappinger D, Kammerlander C, Hak DJ, Blauth M. Low-energy osteoporotic pelvic fractures. Arch Orthopaed Trauma Surg. 2010;130(9):1167–75.

    Google Scholar 

  100. Biffl WL, Smith WR, Moore EE, Gonzalez RJ, Morgan SJ, Hennessey T, et al. Evolution of a multidisciplinary clinical pathway for the management of unstable patients with pelvic fractures. Ann Surg. 2001;233(6):843–50.

    Google Scholar 

  101. Wolinsky PR. Assessment and management of pelvic fracture in the hemodynamically unstable patient. Orthoped Clin North Am. 1997;28(3):321–9.

    Google Scholar 

  102. McMahon DJ, Schwab CW, Kauder D. Comorbidity and the elderly trauma patient. World J Surg. 1996;20(8):1113–9, discussion 9–20.

    Google Scholar 

  103. Gruen GS, Leit ME, Gruen RJ, Peitzman AB. The acute management of hemodynamically unstable multiple trauma patients with pelvic ring fractures. J Trauma. 1994;36(5):706–11, discussion 11–3.

    Google Scholar 

  104. Velmahos GC, Toutouzas KG, Vassiliu P, Sarkisyan G, Chan LS, Hanks SH, et al. A prospective study on the safety and efficacy of angiographic embolization for pelvic and visceral injuries. J Trauma. 2002;53(2):303–8, discussion 8.

    Google Scholar 

  105. O’Brien DP, Luchette FA, Pereira SJ, Lim E, Seeskin CS, James L, et al. Pelvic fracture in the elderly is associated with increased mortality. Surgery. 2002;132(4):710–4, discussion 4-5.

    Google Scholar 

  106. Henry SM, Pollak AN, Jones AL, Boswell S, Scalea TM. Pelvic fracture in geriatric patients: a distinct clinical entity. J Trauma. 2002;53(1):15–20.

    Google Scholar 

  107. Kimbrell BJ, Velmahos GC, Chan LS, Demetriades D. Angiographic embolization for pelvic fractures in older patients. Arch Surg. 2004;139(7):728–32, discussion 32–3.

    Google Scholar 

  108. Starr AJ, Griffin DR, Reinert CM, Frawley WH, Walker J, Whitlock SN, et al. Pelvic ring disruptions: prediction of associated injuries, transfusion requirement, pelvic arteriography, complications, and mortality. J Orthopaed Trauma. 2002;16(8):553–61.

    Google Scholar 

  109. Matityahu A, Elson J, Morshed S, Marmor M. Survivorship and severe complications are worse for octogenarians and elderly patients with pelvis fractures as compared to adults: data from the National Trauma Data Bank. J Osteopor. 2012;2012:475739.

    Google Scholar 

  110. Mundy AR. Pelvic fracture injuries of the posterior urethra. World J Urol. 1999;17(2):90–5.

    Google Scholar 

  111. Carroll PR, McAninch JW. Major bladder trauma: mechanisms of injury and a unified method of diagnosis and repair. J Urol. 1984;132(2):254–7.

    Google Scholar 

  112. Corriere Jr JN, Sandler CM. Management of the ruptured bladder: seven years of experience with 111 cases. J Trauma. 1986;26(9):830–3.

    Google Scholar 

  113. Koraitim MM, Marzouk ME, Atta MA, Orabi SS. Risk factors and mechanism of urethral injury in pelvic fractures. Br J Urol. 1996;77(6):876–80.

    Google Scholar 

  114. Perry MO, Husmann DA. Urethral injuries in female subjects following pelvic fractures. J Urol. 1992;147(1):139–43.

    Google Scholar 

  115. Aihara R, Blansfield JS, Millham FH, LaMorte WW, Hirsch EF. Fracture locations influence the likelihood of rectal and lower urinary tract injuries in patients sustaining pelvic fractures. J Trauma. 2002;52(2):205–8, discussion 8–9.

    Google Scholar 

  116. Bjurlin MA, Fantus RJ, Mellett MM, Goble SM. Genitourinary injuries in pelvic fracture morbidity and mortality using the National Trauma Data Bank. J Trauma. 2009;67(5):1033–9.

    Google Scholar 

  117. Basta AM, Blackmore CC, Wessells H. Predicting urethral injury from pelvic fracture patterns in male patients with blunt trauma. J Urol. 2007;177(2):571–5.

    Google Scholar 

  118. Morgan DE, Nallamala LK, Kenney PJ, Mayo MS, Rue 3rd LW. CT cystography: radiographic and clinical predictors of bladder rupture. Am J Roentgenol. 2000;174(1):89–95.

    Google Scholar 

  119. Cass AS, Luxenberg M. Features of 164 bladder ruptures. J Urol. 1987;138(4):743–5.

    Google Scholar 

  120. Corriere Jr JN, Sandler CM. Mechanisms of injury, patterns of extravasation and management of extraperitoneal bladder rupture due to blunt trauma. J Urol. 1988;139(1):43–4.

    Google Scholar 

  121. Udekwu PO, Gurkin B, Oller DW. The use of computed tomography in blunt abdominal injuries. Am Surg. 1996;62(1):56–9.

    Google Scholar 

  122. Hochberg E, Stone NN. Bladder rupture associated with pelvic fracture due to blunt trauma. Urology. 1993;41(6):531–3.

    Google Scholar 

  123. Avey G, Blackmore CC, Wessells H, Wright JL, Talner LB. Radiographic and clinical predictors of bladder rupture in blunt trauma patients with pelvic fracture. Acad Radiol. 2006;13(5):573–9.

    Google Scholar 

  124. Belis JA, Recht KA, Milam DF. Simultaneous traumatic bladder perforation and disruption of the prostatomembranous urethra. J Urol. 1979;122(3):412–4.

    Google Scholar 

  125. Palmer JK, Benson GS, Corriere Jr JN. Diagnosis and initial management of urological injuries associated with 200 consecutive pelvic fractures. J Urol. 1983;130(4):712–4.

    Google Scholar 

  126. Cass AS, Gleich P, Smith C. Simultaneous bladder and prostatomembranous urethral rupture from external trauma. J Urol. 1984;132(5):907–8.

    Google Scholar 

  127. Deibert CM, Spencer BA. The association between operative repair of bladder injury and improved survival: results from the National Trauma Data Bank. J Urol. 2011;186(1):151–5.

    Google Scholar 

  128. Brewer ME, Wilmoth RJ, Enderson BL, Daley BJ. Prospective comparison of microscopic and gross hematuria as predictors of bladder injury in blunt trauma. Urology. 2007;69(6):1086–9.

    Google Scholar 

  129. Sandler CM, Goldman SM, Kawashima A. Lower urinary tract trauma. World J Urol. 1998;16(1):69–75.

    Google Scholar 

  130. Doyle SM, Master VA, McAninch JW. Appropriate use of CT in the diagnosis of bladder rupture. J Am Coll Surg. 2005;200(6):973.

    Google Scholar 

  131. Horstman WG, McClennan BL, Heiken JP. Comparison of computed tomography and conventional cystography for detection of traumatic bladder rupture. Urol Radiol. 1991;12(4):188–93.

    Google Scholar 

  132. Dubinsky TJ, Deck A, Mann FA. Sonographic diagnosis of a traumatic intraperitoneal bladder rupture. Am J Roentgenol. 1999;172(3):770.

    Google Scholar 

  133. Cass AS, Luxenberg M. Management of extraperitoneal ruptures of bladder caused by external trauma. Urology. 1989;33(3):179–83.

    Google Scholar 

  134. Elliott SP, McAninch JW. Extraperitoneal bladder trauma: delayed surgical management can lead to prolonged convalescence. J Trauma. 2009;66(1):274–5.

    Google Scholar 

  135. Mundy AR, Andrich DE. Pelvic fracture-related injuries of the bladder neck and prostate: their nature, cause and management. BJU Int. 2010;105(9):1302–8.

    Google Scholar 

  136. Kim FJ, Chammas Jr MF, Gewehr EV, Campagna A, Moore EE. Laparoscopic management of intraperitoneal bladder rupture secondary to blunt abdominal trauma using intracorporeal single layer suturing technique. J Trauma. 2008;65(1):234–6.

    Google Scholar 

  137. Brandes S, Borrelli Jr J. Pelvic fracture and associated urologic injuries. World J Surg. 2001;25(12):1578–87.

    Google Scholar 

  138. Black PC, Miller EA, Porter JR, Wessells H. Urethral and bladder neck injury associated with pelvic fracture in 25 female patients. J Urol. 2006;175(6):2140–4, discussion 4.

    Google Scholar 

  139. Okur H, Kucikaydin M, Kazez A, Turan C, Bozkurt A. Genitourinary tract injuries in girls. Br J Urol. 1996;78(3):446–9.

    Google Scholar 

  140. Patil U, Nesbitt R, Meyer R. Genitourinary tract injuries due to fracture of the pelvis in females: sequelae and their management. Br J Urol. 1982;54(1):32–8.

    Google Scholar 

  141. Mundy AR, Andrich DE. Urethral trauma. Part I: introduction, history, anatomy, pathology, assessment and emergency management. BJU Int. 2011;108(3):310–27.

    Google Scholar 

  142. Martinez-Pineiro L, Djakovic N, Plas E, Mor Y, Santucci RA, Serafetinidis E, et al. EAU guidelines on urethral trauma. Eur Urol. 2010;57(5):791–803.

    Google Scholar 

  143. Moore EE, Cogbill TH, Jurkovich GJ, McAninch JW, Champion HR, Gennarelli TA, et al. Organ injury scaling. III: Chest wall, abdominal vascular, ureter, bladder, and urethra. J Trauma. 1992;33(3):337–9.

    Google Scholar 

  144. Wessells H, Long L. Penile and genital injuries. Urol Clin North Am. 2006;33(1):117–26. vii.

    Google Scholar 

  145. Leddy LS, Vanni AJ, Wessells H, Voelzke BB. Outcomes of endoscopic realignment of pelvic fracture associated urethral injuries at a level 1 trauma center. J Urol. 2012;188(1):174–8.

    Google Scholar 

  146. Flynn BJ, Delvecchio FC, Webster GD. Perineal repair of pelvic fracture urethral distraction defects: experience in 120 patients during the last 10 years. J Urol. 2003;170(5):1877–80.

    Google Scholar 

  147. Phonsombat S, Master VA, McAninch JW. Penetrating external genital trauma: a 30-year single institution experience. J Urol. 2008;180(1):192–5, discussion 5–6.

    Google Scholar 

  148. McAninch JW, Kahn RI, Jeffrey RB, Laing FC, Krieger MJ. Major traumatic and septic genital injuries. J Trauma. 1984;24(4):291–8.

    Google Scholar 

  149. Black PC, Friedrich JB, Engrav LH, Wessells H. Meshed unexpanded split-thickness skin grafting for reconstruction of penile skin loss. J Urol. 2004;172(3):976–9.

    Google Scholar 

  150. Husmann DA, Boone TB, Wilson WT. Management of low velocity gunshot wounds to the anterior urethra: the role of primary repair versus urinary diversion alone. J Urol. 1993;150(1):70–2.

    Google Scholar 

  151. Nomura JT, Sierzenski PR. Ultrasound diagnosis of penile fracture. J Emerg Med. 2010;38(3):362–5.

    Google Scholar 

  152. Fedel M, Venz S, Andreessen R, Sudhoff F, Loening SA. The value of magnetic resonance imaging in the diagnosis of suspected penile fracture with atypical clinical findings. J Urol. 1996;155(6):1924–7.

    Google Scholar 

  153. Gamal WM, Osman MM, Hammady A, Aldahshoury MZ, Hussein MM, Saleem M. Penile fracture: long-term results of surgical and conservative management. J Trauma. 2011;71(2):491–3.

    Google Scholar 

  154. Jezior JR, Brady JD, Schlossberg SM. Management of penile amputation injuries. World J Surg. 2001;25(12):1602–9.

    Google Scholar 

  155. Buckley JC, McAninch JW. Diagnosis and management of testicular ruptures. Urol Clin North Am. 2006;33(1):111–6. vii.

    Google Scholar 

  156. Guichard G, El Ammari J, Del Coro C, Cellarier D, Loock PY, Chabannes E, et al. Accuracy of ultrasonography in diagnosis of testicular rupture after blunt scrotal trauma. Urology. 2008;71(1):52–6.

    Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Urology, University of Kansas Medical Center, Kansas City, KS, USA

    Joshua A. Broghammer M.D., F.A.C.S. & Andrew P. Windsperger M.D.

  2. Department of Urology, University of Minnesota Medical Center, Fairview, Minneapolis, MN, USA

    Sean P. Elliott M.D., M.S., F.A.C.S.

Authors
  1. Joshua A. Broghammer M.D., F.A.C.S.
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Andrew P. Windsperger M.D.
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Sean P. Elliott M.D., M.S., F.A.C.S.
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Joshua A. Broghammer M.D., F.A.C.S. .

Editor information

Editors and Affiliations

  1. Department of Urology and the Landon Center on Aging, The University of Kansas, Kansas City, Kansas, USA

    Tomas Lindor Griebling

Rights and permissions

Reprints and permissions

Copyright information

© 2014 Springer Science+Business Media New York

About this chapter

Cite this chapter

Broghammer, J.A., Windsperger, A.P., Elliott, S.P. (2014). Genitourinary Trauma in Geriatric Patients. In: Griebling, T. (eds) Geriatric Urology. Springer, New York, NY. https://doi.org/10.1007/978-1-4614-9047-0_25

Download citation

  • DOI: https://doi.org/10.1007/978-1-4614-9047-0_25

  • Published:

  • Publisher Name: Springer, New York, NY

  • Print ISBN: 978-1-4614-9046-3

  • Online ISBN: 978-1-4614-9047-0

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation