World Journal of Urology

, Volume 31, Issue 4, pp 913–917 | Cite as

Bladder injuries after external trauma: 20 years experience report in a population-based cross-sectional view

  • Bruno Monteiro Tavares Pereira
  • Caio César Citatini de Campos
  • Thiago Rodrigues Araujo Calderan
  • Leonardo Oliveira Reis
  • Gustavo Pereira Fraga
Original Article

Abstract

Objectives

Report 20 years experience of bladder injuries after external trauma.

Methods

Gender, age, mechanism/location of damage, associated injuries, systolic blood pressure (SBP), Revised Trauma Score (RTS), Injury Severity Score (ISS), Trauma Injury Severity Score (TRISS), complications, and length of stay (LOS) were analyzed in a prospective collected bladder injuries AAST-OIS grade ≥II database (American Association for the Surgery of Trauma Organ Injury Scaling) from 1990 to 2009 in a trauma reference center.

Results

Among 2,575 patients experiencing laparotomy for trauma, 111 (4.3 %) presented bladder ruptures grade ≥II, being 83.8 % (n = 93) males, mean age 31.5 years old (±11.2). Blunt mechanism accounted for 50.5 % (n = 56)–motor vehicle crashes 47.3 % (n = 26), pedestrians hit by a car (29.1 %). Gunshot wounds represented 87.3 % of penetrating mechanism. The most frequent injury was grade IV (51 patients, 46 %). The mean ISS was 23.8 (±11.2), TRISS 0.90 (±0.24), and RTS 7.26 (±1.48). Severity (AAST-OIS), mechanism (blunt/penetrating), localization of the bladder injury (intra/extraperitoneal, associated), and neither concomitant rectum lesion were related to complications, LOS, or death. Mortality rate was 10.8 %. ISS > 25 (p = 0.0001), SBP <90 mmHg (p = 0.0001), RTS <7.84 (p = 0.0001), and pelvic fracture (p = 0.0011) were highly associated with grim prognosis and death with hazard ratios of 5.46, 2.70, 2.22, and 2.06, respectively.

Conclusions

Trauma scores and pelvic fractures impact survival in bladder trauma. The mortality rate has remained stable for the last two decades.

Keywords

Bladder trauma Survival Prognosis Trauma score Pelvic fracture Rectum injury Blunt Penetrating Mechanism 

Notes

Conflict of interest

None.

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Copyright information

© Springer-Verlag 2012

Authors and Affiliations

  • Bruno Monteiro Tavares Pereira
    • 1
  • Caio César Citatini de Campos
    • 2
  • Thiago Rodrigues Araujo Calderan
    • 3
  • Leonardo Oliveira Reis
    • 4
  • Gustavo Pereira Fraga
    • 1
  1. 1.Division of Trauma Surgery, Faculty of Medical SciencesUniversity of Campinas (UNICAMP)CampinasBrazil
  2. 2.Faculty of Medical SciencesUniversity of Campinas (UNICAMP)CampinasBrazil
  3. 3.Resident of Division of Trauma Surgery, Faculty of Medical SciencesUniversity of Campinas (UNICAMP)CampinasBrazil
  4. 4.Division of Urology, Faculty of Medical SciencesUniversity of Campinas (UNICAMP)CampinasBrazil

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