title: Major genitourinary-related bicycle trauma: Results from 20 years at a level-1 trauma center.
abstract: BACKGROUND
  Epidemiological studies have shown that bicycle trauma is associated with genitourinary (GU) injuries. Our objective is to characterize GU-related bicycle trauma admitted to a level I trauma center.
  
  
  METHODS
  We queried a prospective trauma registry for bicycle injuries over a 20-year period. Patient demographics, triage data, operative interventions and hospital details were collected.
  
  
  RESULTS
  In total, 1659 patients were admitted with major bicycle trauma. Of these, 48 cases involved a GU organ, specifically the bladder (n=7), testis (n=6), urethra (n=3), adrenal (n=4) and/or kidneys (n=36). The median age of cyclists with GU injuries was 29 (range 5-70). More men were injured versus women (35 versus 13). GU-related bicycle trauma involved a motor vehicle in 52% (25/48) of injuries. The median injury severity score for GU-related bicycle trauma was 17 (range 1-50). The median number of concomitant organ injuries was 2 (range 0-6), the most common of which was the lungs (13/48, 27%) and ribs (13/48, 27%). The majority of GU injured cyclists were admitted to an ICU (15/48, 31%) or hospital floor (12/48, 25%). Operative intervention for a GU-related trauma was low (12/48, 25%). The most common GU organ injured was the kidney (36/48, 75%) however most were managed nonoperatively (33/36, 92%). Bladder injuries most often required operative intervention (6/7, 86%). Mortality following GU-related bicycle trauma was low (2/48, 4%).
  
  
  CONCLUSIONS
  In a large series of bicycle trauma, GU organs were injured in 3% of cases. The majority of cases were managed non-operatively and mortality was low.
authors.affiliation: Department of Urology, University of California - San Francisco, San Francisco, CA, United States. Electronic address: charles.osterberg@ucsf.edu.
authors.forename: E Charles
authors.initials: EC
authors.lastname: Osterberg
authors.affiliation: Department of Urology, University of California - San Francisco, San Francisco, CA, United States. Electronic address: Mohannad.awad@ucsf.edu.
authors.forename: Mohannad A
authors.initials: MA
authors.lastname: Awad
authors.affiliation: Department of Urology, University of California - San Francisco, San Francisco, CA, United States. Electronic address: Tom.gaither@ucsf.edu.
authors.forename: Thomas W
authors.initials: TW
authors.lastname: Gaither
authors.affiliation: Department of Urology, University of California - San Francisco, San Francisco, CA, United States. Electronic address: Thomas.sanford@ucsf.edu.
authors.forename: Thomas
authors.initials: T
authors.lastname: Sanford
authors.affiliation: Department of Urology, King Abdulaziz University, Jeddah, Saudi Arabia. Electronic address: amjadwal@yahoo.com.
authors.forename: Amjad
authors.initials: A
authors.lastname: Alwaal
authors.affiliation: Department of Urology, University of Washington, Seattle, WA, United states. Electronic address: Lindsay.hampson@gmail.com.
authors.forename: Lindsay A
authors.initials: LA
authors.lastname: Hampson
authors.affiliation: Department of Urology, University of California - San Francisco, San Francisco, CA, United States. Electronic address: Jennie.yoo@ucsf.edu.
authors.forename: Jennie
authors.initials: J
authors.lastname: Yoo
authors.affiliation: Department of Urology, University of California - San Francisco, San Francisco, CA, United States. Electronic address: Jack.McAninch@ucsf.edu.
authors.forename: Jack W
authors.initials: JW
authors.lastname: McAninch
authors.affiliation: Department of Urology, University of California - San Francisco, San Francisco, CA, United States. Electronic address: Benjamin.Breyer@ucsf.edu.
authors.forename: Benjamin N
authors.initials: BN
authors.lastname: Breyer
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001265:Athletic Injuries / Q000453:epidemiology*; D001642:Bicycling / Q000293:injuries*; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D015601:Injury Severity Score; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D014193:Trauma Centers; D014481:United States / Q000453:epidemiology; D014566:Urogenital System / Q000293:injuries*; D014947:Wounds and Injuries / Q000453:epidemiology*; D014949:Wounds, Nonpenetrating / Q000453:epidemiology* / Q000209:etiology; D055815:Young Adult
keywords: Bicycle trauma; Cycling; Genitourinary trauma; Trauma registry