Lower Urinary Tract Injuries Associated with Fractured Pelvis

Min, Byung Hoon; Choi, Hi Seog

Abstract

We reviewed 241 consecutive cases of pelvic fractures at the lnje Medical College Paik Hospital in Seoul during the period of 5 years from Jan., l98l to Dec., l985 to establish the relationship between the lower urinary tract injury and fractured pelvis. Of 241 patients with pelvic fractures 44(l8.3%) had lower urinary tract injury. The results were as follows: l. The pelvic fractures occurred most commonly in traffic accident as 62.7% and the age group ranging from 20 to 39 years old was 55.2% of patients with pelvic fracture. 2. Of 273 pelvic fractures in 241 patients unilateral pelvic rami fractures were 47.2%, bilateral pubic rami fractures were 23.1%, acetabular fractures, and Malgaigne fractures in orders of frequency. 3. The most common cause of lower urinary tract injuries associated with pelvic fractures was traffic accident (70.5%), and followed by direct blow, and fall-down in orders. 4. From the view of fracture patterns the lower urinary tract injuries associated with pelvic fractures occurred most commonly in unilateral pubic rami fractures (47.7%), and the ratio of lower urinary tract injuries following fracture patterns were 29.4% of Malgaigne fractures, 23.8% of bilateral pubic rami fractures, and 16.3% of unilateral pubic rami fractures. 5. Of 44 lower urinary tract injuries the urethra alone were injured in 63.6%, the bladder alone in 27.3%, and the bladder and urethra both in 9.1% of the cases. 6. All patients of lower urinary tract injuries associated with pelvic fractures had hematuria, either gross or microscopic, and 97.7% of these cases had gross hematuria.