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Patients' records and imaging were reviewed to identify
injury grades, interventions, outcomes and follow up.
Results: Renal injury was identified in 60 out of 78
patients with a urinary tract injury. Male to female ratio
was 51:9. Average age was 37.5±17.36 (1.5-94.6) years.
The majority sustained blunt trauma 80% (N=48) compared to 20% penetrating (N=12). Injuries were; 12 (20%)
grade 1; 11 (18.3%) grade 2; 17 (28.3%) grade 3; 12 (20%)
grade 4; 5 (8.3%) grade 5 according to American
Association for the Surgery of Trauma (AAST) scale. Early
renal intervention occurred in 10 patients (16.6%), of
which, 5 were managed with IR exclusively, 2 underwent
open renal repair and 1 ureteric stenting. Emergency
nephrectomy was performed in 2 patients (3.3%); both of
whom died from extensive polytrauma. Overall 30-day
mortality was 15% (n=9).
Conclusions: Even for haemodynamically unstable injuries, IR techniques were successful. Emergency nephrectomy remains a rare event even with polytrauma and
laparotomy for associated injuries.
P7-6 Pelvic fracture urethral injury - the
nature of the causative injury correlates
strongly with surgical treatment and outcome
Ivaz S1, Bugeja S1, Frost A1, Dragova M1, Andrich D1,
Mundy A1
1University College London Hospitals, NHS Foundation Trust,
London, United Kingdom

Introduction: We have assessed the specific nature of
the trauma leading to pelvic ring disruption and its relationship to the resulting urethral injury, its surgical treatment and outcome.
Patients and Methods: 106 consecutive patients were
evaluated. 66 patients (62%) were involved in a road traffic
accident (n=33 driver/passenger in a car), 38(36%) in work
/ recreational activities. 2 patients (2%) attempted suicide
by jumping.
Results: Car accidents - lateral compression (LC) fractures n=27, open-book (OB) n=4; Motorcycle\bicycle
accidents - LC n=16, OB n=12, vertical shear
disruptions(VS) n=4; Work\recreational accidents - LC
n=23, OB n=11, VS n=4. The remaining 4 were unclassifiable in this simple way.
Of 69 LC fractures, 34 were "straightforwards" (car injuries n=30, pedestrians n=2, work injuries n=2, not easily
classifiable n=13) and 22 were crush injuries (car injury
n=1, pedestrians n=18, work injury n=3). The other 13
were not easily classifiable.
Surgery (bulbo-prostatic anastomosis) was mobilisation
and anastomosis in 15%, crural separation in 52.5%, inferior pubectomy in 15% and supra-crural re-routing in
17.5%. 60% of the pubectomy cases and 67% of the rerouting patients were crush injuries.

Journal of Clinical Urology 11(1S)
Conclusion: Car drivers and passengers tended to have
less serious injuries and better outcome mainly because
LC fractures seemed to cause less local pelvic trauma and
were associated with shorter defects to bridge. Specifically
there was an 88% chance that the injury would be a
"straightforward" LC injury causing an incomplete rupture with a 92% chance that it can be treated by a step 1
or step 2 BPA.
P7-7 Centralisation of paediatric services:
assessing impact in suspected testicular
torsion
Zimmermann E1, Cichosz R1, Rajjayabun P1
1Alexandra Hospital, Redditch, United Kingdom

Introduction: In our Trust, paediatric services were
recently centralised to a single unit within our multisite configuration - 17 miles from the Urology Centre.
We analysed the impact of this change on the management of patients with suspected testicular torsion. We
examined referral numbers, time to specialist assessment, 'knife-to-skin' time, surgical findings and need for
orchidectomy.
Methods: Using a comprehensive electronic database we
conducted a closed loop audit on suspected testicular torsion outcomes over two 12-month periods, pre and post
paediatric centralisation (2015 and 2017).
Results: We observed that the total number of scrotal
explorations reduced from 41 to 21 - of which 28 and 12
respectively were within the paediatric population. Median
age of patients was 15 (range 4-51) vs 16 (range 4-46).
There was no significant difference in time from presentation to 'knife-to-skin' overall: 195 mins vs 227 mins, p=0.20,
or in the paediatric population: 211 vs 210 mins, p=0.95.
Overall, five patients exceeded a 6-hour target of 'knifeto-skin' time during 2015 compared to one in 2017.There
were in total 6 vs 4 confirmed torsions on exploration - all
testes were viable. No orchidectomy was required in
either period of analysis.
Conclusion: Since paediatric services have been centralised away from our Urology Centre there has been a
reduction in patients breaching the 6-hour target.This may
reflect a reduction in patient transfers, with Urological
surgeons travelling to the new paediatric site. Total numbers of referrals have fallen which may indicate a shift of
some patients to neighbouring units.
P7-8 A multicentre prospective study
evaluating the outcomes from emergency
scrotal exploration
Morton S1, Fitzpatrick J1, Haq K1, Lee T1, Luk A1,
MacKenzie K1, O'Hare T1, Tahira A1, Harding C1
1Freeman Hospital, Newcastle, United Kingdom



Table of Contents for the Digital Edition of JCU - Abstracts of the BAUS 2018 Scientific Meeting - June 2018

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