Traumatic urologic injuries in Ile-Ife, Nigeria

BACKGROUND: In a developing country with limited healthcare resources, traumatic injuries and their management pose a significant challenge to healthcare delivery. AIM: To highlight the challenges in the management of traumatic urologic injuries in patients in our setting. SETTING AND DESIGN: Patients presenting with traumatic injuries to the urinary tract, between January 1996 and December 2005, in a University Teaching Hospital in Southwestern Nigeria were the subjects of this study. PATIENTS AND METHODS: Clinical records of patients who had such injuries were reviewed. RESULTS: Ninety injuries occurred in 86 patients including 77 males and 9 females aged 14–68 years. Fourteen (15.5%) of the injuries involved the kidneys, urinary bladder was involved in 23 (25.6%) and the male urethra in 53 (58.9%) injuries. The mechanisms of injury were road traffic accidents in 52 (60.5%) patients, straddle injuries in 18 (20.9%), trauma to the back in 8 (9.3%), falls from a height in 6 (7.0%) and gunshot injuries in 2 (2.3%) patients. Associated injuries include pelvic fractures in 33 (38.4%) patients, limb bone fractures in 13 (14.1%), intestinal injuries in 12 (13.0%) and spinal injuries in 8 (8.7%) patients. In most patients, diagnosis was made based on clinical suspicion and minimal investigations such as abdominal ultrasound, urethrocystoscopy and/or urethrocystography. The outcome was good in most patients and mortality was recorded in only 2 (2.3%) patients who had concomitant spinal and burns injuries. CONCLUSION: Prompt management instituted on clinical suspicion of injuries presents a good outcome in patients in a limited resource setting.