Norelyakin KARA, Paul NEUVILLE, Nadim BALLOUT, Amina NDIAYE
Journal of Urological Surgery - 2026;13(2):80-89
Objective: Traffic accidents are the most frequent cause of genitourinary injuries. There exists a paucity of data on lower genitourinary injuries (LGUI) after traffic accidents. The main objective of our study was to analyze the incidence and clinical patterns of LGUI in traffic accidents. The secondary objective was to determine the LGUI predictive factors, and the associations with lesions. Materials and Methods: Patient cases were extracted from the trauma registry of the French department of Rhone from 1995 to 2015. We assessed the LGUI presented by each road user category. Injuries were coded with the abbreviated injury scale and the injury severity score. Multivariate prediction models and the DataShared-SepLogit method were used for data analysis. Results: Of 178,625 victims, 591 (0.33%) presented with LGUI, 53% were motorcyclists, and 26.4% were cyclists. The most commonly injured organ was testicles (41%) followed by scrota (20%) and penises (15%). Among the 312 motorcyclists, testicular (60%) and scrotal (24%) injuries were the most frequent lesions. Among the 156 cyclists, penile injuries were the most frequent (27%). Among the 54 motorists, bladder (46%) and testicle (20%) injuries were the most frequent. For motorcyclists, motorists, and pedestrians, compared to women, a four, three, and two-fold risk of LGUI was observed for men, respectively. For cyclists, being a man was a protective factor. Testicular lesions were strongly associated with penile lesions for motorists and cyclists. Bladder injuries were strongly associated with pelvic fractures for pedestrians and motorists. Within the 78 testicular traumatisms with clinically available records, 69% (54) had an ultrasound examination and 12.5% (16) had an albuginea rupture. The salvage rates for patients who had surgery after blunt testicular trauma were 64% (7 albuginea repairs for 11 albuginea ruptures) and 33% after open wound trauma. Conclusion: LGUI is an infrequent trauma after traffic accidents, with testicular injuries being the most commonly injured. Physicians must maintain a high awareness of external genitalia injuries in motorcyclists and cyclists.
