Journal article
Current Management of Extraperitoneal Bladder Injuries: Results from the Multi-Institutional Genito-Urinary Trauma Study (MiGUTS)
The Journal of urology, Vol.204(3), pp.538-544
09/2020
DOI: 10.1097/JU.0000000000001075
PMCID: PMC8717861
PMID: 32259467
Abstract
We studied the current management trends for extraperitoneal bladder injuries and evaluated the use of operative repair versus catheter drainage, and the associated complications with each approach.
We prospectively collected data on bladder trauma from 20 level 1 trauma centers across the United States from 2013 to 2018. We excluded patients with intraperitoneal bladder injury and those who died within 24 hours of hospital arrival. We separated patients with extraperitoneal bladder injuries into 2 groups (catheter drainage vs operative repair) based on their initial management within the first 4 days and compared the rates of bladder injury related complications among them. Regression analyses were used to identify potential predictors of complications.
From 323 bladder injuries we included 157 patients with extraperitoneal bladder injuries. Concomitant injuries occurred in 139 (88%) patients with pelvic fracture seen in 79%. Sixty-seven patients (43%) initially underwent operative repair for their extraperitoneal bladder injuries. The 3 most common reasons for operative repair were severity of injury or bladder neck injury (40%), injury found during laparotomy (39%) and concern for pelvic hardware contamination (28%). Significant complications were identified in 23% and 19% of the catheter drainage and operative repair groups, respectively (p=0.55). The only statistically significant predictor for complications was bladder neck or urethral injury (RR 2.69, 95% 1.21-5.97, p=0.01).
In this large multi-institutional cohort, 43% of patients underwent surgical repair for initial management of extraperitoneal bladder injuries. We found no significant difference in complications between the initial management strategies of catheter drainage and operative repair. The most significant predictor for complications was concomitant urethral or bladder neck injury.
Details
- Title: Subtitle
- Current Management of Extraperitoneal Bladder Injuries: Results from the Multi-Institutional Genito-Urinary Trauma Study (MiGUTS)
- Creators
- Ross E Anderson - University of UtahSorena Keihani - University of UtahRachel A Moses - Dartmouth–Hitchcock Medical CenterAlexander P Nocera - University of Alabama at BirminghamJ Patrick Selph - University of Alabama at BirminghamClara M Castillejo Becerra - The Ohio State University Wexner Medical CenterNima Baradaran - The Ohio State University Wexner Medical CenterKatie Glavin - University of Kansas Medical CenterJoshua A Broghammer - University of Kansas Medical CenterChirag S Arya - Cooper University HospitalRachel L Sensenig - Cooper University HospitalMichael E Rezaee - Dartmouth–Hitchcock Medical CenterBradley J Morris - Intermountain Medical CenterSarah Majercik - Intermountain Medical CenterTimothy Hewitt - Oakland UniversityFrank N Burks - Oakland UniversityIan Schwartz - Hennepin County Medical CenterSean P Elliott - Hennepin County Medical CenterXian Luo-Owen - Loma Linda University Medical CenterKaushik Mukherjee - Loma Linda University Medical CenterPeter B Thomsen - University of IowaBradley A Erickson - University of IowaBrandi D Miller - Detroit Medical CenterRichard A Santucci - Detroit Medical CenterLaDonna Allen - Department of Surgery, Health Tyler, Tyler, TexasScott Norwood - The University of Texas Health Science Center at TylerCameron N Fick - Hospital of the University of PennsylvaniaBrian P Smith - Hospital of the University of PennsylvaniaJoshua Piotrowski - Medical College of WisconsinChristopher M Dodgion - Medical College of WisconsinErik S DeSoucy - University of California Davis Medical CenterScott Zakaluzny - University of California Davis Medical CenterDennis Y Kim - UCLA Medical CenterBenjamin N Breyer - University of California, San FranciscoBarbara U Okafor - Brigham and Women's HospitalReza Askari - Brigham and Women's HospitalJacob W Lucas - Einstein Healthcare NetworkJay Simhan - Einstein Healthcare NetworkSeyyed Saeed Khabiri - Kermanshah University of Medical SciencesRaminder Nirula - University of UtahJeremy B Myers - University of Utah
- Resource Type
- Journal article
- Publication Details
- The Journal of urology, Vol.204(3), pp.538-544
- DOI
- 10.1097/JU.0000000000001075
- PMID
- 32259467
- PMCID
- PMC8717861
- NLM abbreviation
- J Urol
- ISSN
- 1527-3792
- eISSN
- 1527-3792
- Grant note
- UL1 TR002538 / NCATS NIH HHS UL1 TR001067 / NCATS NIH HHS UL1 TR000105 / NCATS NIH HHS UL1 RR025764 / NCRR NIH HHS
- Language
- English
- Date published
- 09/2020
- Academic Unit
- Urology
- Record Identifier
- 9984319985402771
Metrics
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