Genitourinary injuries

Since then classification systems that related the pattern of fracture to the nature of the applied force have been introduced (Pennal et al. 1980b). This is described as the force-vector classification. There have been suggested refinements that have identified a progression in the severity of injuries and identified those fractures which are more likely to be unstable or be associated with pelvic haemorrhage and genitourinary injury (Young et al. 1986a,b Dalal et al. 1989 Ben-Menachem et al. 1991). 

Selikowitz SM (1977) Penetrating high-velocity genitourinary injuries. Part I. Statistics, mechanisms, and renal wounds. Urology 9 371-376... 

There is very little in the published literature about specific genitourinary injuries, although clearly the external genitalia (in men) are at risk of burns and fragment injury and the internal genitalia are at risk of penetrating injury. 

Recent non-genitourinary surgery degree of completeness of injury Functional Ul... 

Injury of any tissue gives rise to an immediate inflammatory response and it is probable that this initial response is primarily aimed at priming the process of repair. It is likely that adaptive immunity has evolved in the context of tissue damage induced by infection and the production of an immune response is seen to be most efficient in those tissues most likely to be at risk of a primary infection, e.g., the nasal-oral mucosa, the respiratory, intestinal, and genitourinary surfaces, and the dermis. The CNS is not a site of primary infection and the invasion of the CNS by organisms following systemic infection is limited, presumably by virtue of the properties of the brain vasculature, and when it occurs it seems to reflect more the adaptive ability of the infective agent. 

The likelihood of associated visceral, genitourinary and neurological injuries is very low in type I and 11 injuries, moderate in type 111 and high in type IV. Type II and III injuries usually require admission to hospital for observation and analgesia and CT is often required to confirm that the fracture is not type IV. Patients are mobilised once pain allows and long term sequelae are uncommon. 

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