Abstracts from the Abstracts from the Mid-Atlantic Section of the AUA 2021

© The Canadian Journal of Urology TM : International Supplement, October 2021 Moderated Poster Session 6: Trauma/Sexual Dysfunction Characterizing the Epidemiology and Management of Urological Trauma in Baltimore, Maryland I. Pan 1 , M. Rostom 1 , S. Wang 1 , A. Holler 1 , N. Gupta 1 , R. Fransman 2 , A. Kent 2 , M. Manukyan 2 , M. Subramarian 2 , A. Cohen 1 1 Johns Hopkins Brady Urology Institute, Baltimore, MD, USA; 2 Johns Hopkins Department of General Surgery, Baltimore, MD, USA Introduction andObjective: Trauma is the leading cause of death in patients under 45 causing 120,000 deaths annually in the United States, 10% of which are genitourinary. Here, we aim to assess the frequency, management, and course of various urological traumas at an urbanmedical center with the goal of improving management of these patients. Methods: 211 patients were identified who had sustained injuries to the genitourinary organs and were treated at Johns Hopkins from 2014-2021. Various clinical metrics were assessed, including length of stay (LOS), number of operations, specialties consulted, and presenting symptoms. Results: A majority of urological trauma cases (125, 59%) were due to violent crime, defined as gun-shot wounds (GSW), stab wounds and physical altercations. The most common causes of injury were GSW (103, 48.8%) and motor vehicle accidents (58, 27.5%). Hematuria was present in 55% (116) of urological injuries. 93 (44%) cases involved a urological consult, with 37 (21%) seen in outpatient urology clinic. Furthermore, while renal/adrenal injuries were the most commonly injured organs (123, 58%), these injuries were the least likely to involve a urological consult (p < 0.001). Average overall LOS was 11.7 days, the highest for ureteral injuries (21.2 days) and lowest for urethral injuries (5.3 days). Mortality from such injuries was difficult to assess as patients that were deceased on arrival were excluded from our cohort, and several patients were lost to follow-up post-operatively. Conclusions: Urological trauma is amajor public health concern, particularly in inner city settings with high violent crime. Patients who experience urological trauma are often lost to follow-up, raising concerns for long term outcomes – especially as such outcomes are necessary for determining consequences of conservative and surgical management. MP6-13 Effect of Urology Consult on Renal Trauma Outcomes S. Wang, M. Rostom, N. Gupta, A. Holler, I. Pan, C. Torres, R. Fang, K. Stevens, E. Haut, A. Cohen Johns Hopkins University School of Medicine, Baltimore, MD, USA Introduction and Objective: Renal trauma is unique in that acute management involves the trauma team, primarily urology, or joint management. The ideal management pathway has yet to be established. We aim to describe rates of urology consultation following renal trauma and assess subsequent impact on outcomes. Methods: We conducted an IRB-approved retrospective review of patients at a Level I trauma center sustaining renal trauma. We collected demographic, radiologic, and surgical information. The primary endpoints were nephrectomy, change in creatinine, post-operative AKI, and need for dialysis during hospital admission. Analyses were performed using STATA with p<0.05 considered significant. Results: From2014-2021, 127 patients withmedian age 29 years incurred renal trauma. In 98 (77.2%) cases, urology was not consulted. Injury severity score did not significantly differ among cases with and without a urology consult (22.18 vs. 21.18;p=0.357). The AAST grade was only reported in 10 (7.9%) patients. The risk ratio of poor renal outcome with consult to urology was 1.33 (p=0.230). The risk ratios of nephrectomy, need for dialysis, AKI with consult to urology were 1.13 (p=0.441), 1.0 (p=0.641), and 1.59 (p=0.170), respectively. Conclusions: Urology consult was not associated with a statistically significant difference in indicators of poor renal outcome. Our data support that current management strategies with and without urology optimize outcomes. In our center, future quality improvement may involve better compliance with AAST Renal Trauma Grading, which was lacking. MP6-12 44