scholarly journals Management of pelvic fracture-associated urethral injuries: A survey of Canadian urologists

2017 ◽  
Vol 11 (3-4) ◽  
pp. 74
Author(s):  
Nathan Colin Wong ◽  
Christopher B. Allard ◽  
Shawn Dason ◽  
Patricia Farrugia ◽  
Mohit Bhandari ◽  
...  
Keyword(s):  
Pelvic Fracture ◽  
Trauma Centre ◽  
Optimal Management ◽  
Immediate Reconstruction ◽  
Web Based ◽  
Orthopedic Surgeons ◽  
Item Questionnaire ◽  
Delayed Repair ◽  
Urethral Injuries ◽  
Urological Injuries

Introduction: The management of pelvic fracture-associated urethral injuries (PFUI) is not standardized and optimal management is controversial. We surveyed Canadian urologists about their experiences and opinions regarding optimal management of PFUI.Methods: Canadian urologists were surveyed via an anonymous, bilingual, web-based, 12-item questionnaire. A total of 735 Canadian urologists were invited to participate via email distributed by the Canadian Urological Association.Results: Of the 146 urologists who participated (19.9% response rate), the majority practice at a trauma centre (53.2%), but manage only 1‒5 PFUI/year (71.5%). Most participants (82.6%) favour primary realignment compared to suprapubic (SP) tube with delayed repair (15.3%) and immediate reconstruction (2.1%). Compared to SP diversion and delayed repair, the majority of participants believe primary realignment is associated with equivocal incontinence (61.2%) and erectile dysfunction rates (75.8%), but has lower stricture rates (73.0%). Among respondents who perform primary realignment, 45.4% concurrently place a SP tube, while 54.6% do not. While 91% believe SP tubes do not increase the risk of pelvic hardware infections, 31.6% report that orthopedic surgeons alter their management of pelvic fractures in the presence of a SP tube.Conclusions: Most Canadian urologist respondents — even those practicing at trauma centres — manage very few PFUIs/year. There is reasonable consensus among respondents that primary realignment is favourable to delayed or immediate reconstruction, but discordance on whether or not to place concurrent SP tubes. The urological and orthopedic consequences of SP tubes in the management of traumatic urological injuries warrant further investigation.

scholarly journals Delayed repair of pelvic fracture urethral injuries: Preoperative decision-making

2015 ◽  
Vol 13 (3) ◽  
pp. 217-220 ◽  
Author(s):  
Nadir I. Osman ◽  
Altaf Mangera ◽  
Richard D. Inman ◽  
Christopher R. Chapple
Keyword(s):  
Decision Making ◽  
Pelvic Fracture ◽  
Delayed Repair ◽  
Urethral Injuries

What constitutes complexity rather than difficulty in the surgical reconstruction of pelvic fracture-related urethral injuries?

2021 ◽  
Vol 79 ◽  
pp. S1605
Author(s):  
J. Olphert ◽  
S.L. Ivaz ◽  
S. Bugeja ◽  
N. Jeffery ◽  
A. Frost ◽  
...  
Keyword(s):  
Pelvic Fracture ◽  
Surgical Reconstruction ◽  
Urethral Injuries

Evaluating the Awareness, Access, and Use of the State Indicator Report on Physical Activity, 2010

2013 ◽  
Vol 10 (6) ◽  
pp. 863-870
Author(s):  
Kelly Mattran ◽  
Carmen Harris ◽  
Jan Jernigan ◽  
Janet Fulton
Keyword(s):  
Physical Activity ◽  
Physical Activity Promotion ◽  
National Data ◽  
Web Based ◽  
The Public ◽  
Government Response ◽  
Item Questionnaire ◽  
Activity Promotion ◽  
E Mail ◽  
Share Information

Background:The State Indicator Report on Physical Activity, 2010 (SIRPA) and accompanying resources provide information for practitioners to promote physical activity. This study evaluated awareness, access, and use of materials among physical activity practitioners.Methods:A Web-based survey assessed awareness, access and use among respondents. The 26-item questionnaire assessed the usability of products developed by the federal government. Response frequencies and 95% confidence intervals were reported.Results:Response rate was 27% (135 of 508). Awareness of material was from e-mail (35.6%) or partner Websites (37.8%). One-third of respondents (33.3%) accessed materials at least once a month, but 39.3% reported no use. The SIRPA (44.4%) and state-specific action guides (34.1%) were used the most. Materials were used to compare state-specific to national data (57.0%) and to present data to the public (41.5%). Most respondents (83%) reported public health partners as a target audience, and 91.8% were likely to share information in the future.Conclusions:SIRPA awareness was primarily through electronic communication, and two-thirds of respondents used the materials. Respondents accessed materials for state comparisons and public distribution. Increasing the use of federal physical activity promotion materials involves considering design and dissemination features related to the needs of practitioners.

Pre-hospital and emergency department management of pelvic fractures and major trauma centre status: Has practice changed?

Trauma ◽  
2016 ◽  
Vol 19 (3) ◽  
pp. 207-211
Author(s):  
Jonathan Barnes ◽  
Philip Thomas ◽  
Ramsay Refaie ◽  
Andrew Gray
Keyword(s):  
Emergency Department ◽  
Clinical Practice ◽  
Pelvic Fracture ◽  
Major Trauma ◽  
High Energy ◽  
Trauma Centre ◽  
Pelvic Fractures ◽  
Major Trauma Centre ◽  
Initial Imaging ◽  
One Year

Introduction Pelvic fractures are indicative of high-energy injuries and carry a significant morbidity and mortality and pelvic binders are used to stabilise them in both the pre-hospital and emergency department setting. Our unit gained major trauma centre status in April 2012 as part of a national programme to centralise trauma care and improve outcomes. This study investigated whether major trauma centre status led to a change in workload and clinical practice at our centre. Methods A retrospective analysis of all patients admitted with a pelvic fracture for the six-month periods before, after and at one-year following major trauma centre status designation. Data were retrospectively collected from electronic patient records and binder placement assessed using an accepted method. Patients with isolated pubic rami fractures were excluded. Results Overall, 6/16 (37.5%) pelvic fracture admissions had a binder placed pre-major trauma centre status, rising to 14/34 (41.2%) immediately post-major trauma centre status and 22/32 (68.8%) ( p = 0.025) one year later. Binders were positioned accurately in 4 patients (80%, one exclusion) pre-major trauma centre status, 12 (92.4%) post-major trauma centre status and 22 (100%) at one year. CT imaging was the initial imaging used in 9 (56.3%) patients pre-major trauma centre status, 29 (85.3%) ( p = 0.04) post-major trauma centre status and 27 (84.4%) at one year. Discussion Pelvic fracture admissions doubled following major trauma centre status. Computed tomography, as the initial imaging modality, increased significantly with major trauma centre status, likely a reflection of the increased resources made available with this change. Although binder application rates did not change immediately, a significant improvement was seen after one year, with binder accuracy increasing to 100%. This suggests that although changes in clinical practice often do not occur immediately, with the increased infrastructure and clinical exposure afforded through centralisation of trauma services, they will occur, ultimately leading to improvements in trauma patient care.

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