Lower Genitourinary Injuries Following Traffic Accidents: Epidemiology, Clinical Characteristics and Outcomes

Kara, Norelyakin; Neuville, Paul; Ballout, Nadim; Ndiaye, Amina · 2026 · Crossref

DOI: 10.4274/jus.galenos.2025.2025-6-10

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Summary

This study addresses the paucity of data regarding lower genitourinary injuries (LGUI) resulting from road traffic accidents. While traffic accidents are a leading cause of genitourinary trauma, specific epidemiological patterns, clinical characteristics, and outcomes for LGUI—encompassing injuries to the testicles, penis, bladder, urethra, scrotum, vagina, and vulva—remain poorly understood. The research aimed to define the incidence and clinical patterns of these injuries, identify predictive factors, and determine associations between specific lesions to improve early detection and management protocols. The researchers conducted a retrospective analysis using data from the official trauma registry of the French department of Rhone, covering 178,625 traffic accident victims from 1996 to 2015. Injuries were coded using the Abbreviated Injury Scale (AIS) and Injury Severity Score (ISS). The study employed multivariate prediction models and a novel statistical method, DataShared-SepLogit, to estimate conditional associations between bodily injuries across different road user groups. Clinical records, including radiological exams and management approaches, were retrospectively reviewed for patients with available data from 2005 to 2015. Among the total cohort, 591 patients (0.33%) sustained LGUI. Motorcyclists (53%) and cyclists (26.4%) were the most affected groups, with 83.9% of victims being male. Testicular injuries were the most common (41%), followed by scrotal (20%) and penile (15%) injuries. Specific patterns emerged by user type: motorcyclists frequently suffered testicular (60%) and scrotal (24%) injuries, while cyclists predominantly experienced penile injuries (27%). Men faced a significantly higher risk of LGUI than women for motorists, motorcyclists, and pedestrians, whereas being male was a protective factor for cyclists. The DataShared-SepLogit analysis revealed strong associations between testicular and penile lesions in motorists and cyclists, and between bladder injuries and pelvic fractures in pedestrians and motorists. Clinical review of 78 testicular injuries showed that blunt trauma often resulted in severe outcomes like albuginea ruptures, with surgical salvage rates of 64% for blunt trauma and 33% for open wounds. Urethral and bladder injuries were frequently associated with pelvic fractures and required prolonged catheterization or surgery. The study concludes that LGUI is an infrequent but significant consequence of traffic accidents, with distinct injury profiles based on road user type. The findings highlight the importance of maintaining high clinical suspicion for external genitalia injuries, particularly in motorcyclists and cyclists. The identified injury associations, such as the link between testicular and penile trauma, can aid in early diagnosis. Furthermore, the data suggests that current trauma protocols may need refinement to address underdiagnosed injuries, potentially reducing morbidity and persistent genital or urinary dysfunction. This large-scale registry analysis provides critical evidence for improving the management and outcomes of LGUI in trauma care.

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Topics

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• vru crash typology