Blunt traumatic female urethral and bladder neck injuries: a 15-year single-institution experience

PurposeTo describe our experience in the management and outcomes of female patients with urethral or bladder neck (BN) injury at a high-volume Level 1 trauma center.MethodsA retrospective chart review of all female patients with urethral or BN injury by blunt trauma mechanism admitted to a Level 1 trauma center between 2005 and 2019 was performed.ResultsTen patients met study criteria with median age 36.5 years. All had concomitant pelvic fractures. All injuries were confirmed operatively, with no delayed diagnoses. Two patients were lost to follow up. One patient was not eligible for early repair of urethral injury and had two repairs of a urethrovaginal fistula. Two of seven (29%) patients who underwent early repair of their injury had an early Clavien grade > 2 complication, with none reporting long-term complications at median follow-up of 15.2 months.ConclusionsIntraoperative evaluation is critical in the diagnosis of female urethral and BN injury. In our experience, acute surgical complications are not uncommon after the management of such injuries. However, there were no reported long-term complications in those patients who had prompt management of their injury. This aggressive diagnostic and surgical strategy is instrumental in attaining excellent surgical outcomes.

Automated summary

This study retrospectively analyzed the management and outcomes of female patients with urethral or bladder neck injury at a high-volume Level 1 trauma center between 2005 and 2019. The results showed that female patients with urethral or bladder neck injury had a risk of complications during acute surgical management, but long-term complications could be avoided through prompt management.