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RESEARCH PAPER
Analysis of bladder injuries using the AAST scale in the material of the Department of Urology of the Central Clinical Hospital of the Ministry of National Defense Military Institute of Medicine in 2018-2022
 
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1
Wojskowy Instytut Medyczny – Państwowy Instytut Badawczy, Klinika Urologii Ogólnej, Czynnościowej i Onkologicznej, Polska
 
2
Oddział Urologii, Szpital Powiatowy w Kozienicach, Polska
 
 
Submission date: 2022-08-18
 
 
Acceptance date: 2022-08-24
 
 
Publication date: 2022-12-30
 
 
Corresponding author
Agnieszka Grabińska   

Wojskowy Instytut Medyczny – Państwowy Instytut Badawczy, Klinika Urologii Ogólnej, Czynnościowej i Onkologicznej, Wiatraczna, 29/lok. 117, 04-384, Warszawa, Polska
 
 
LW 2022;100(4):243-246
 
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ABSTRACT
Introduction and objective: Bladder injuries account for 3% of all pelvic injuries. They rarely require urgent surgical intervention. The aim of the study was to analyze bladder injuries with an attempt to use the AAST scale to assess their severity. Results: 21 patients with bladder trauma were hospitalized at the Central Clinical Hospital of the Ministry of National Defense Military Institute of Medicine between 2018-2022. Extraperitoneal bladder trauma was found in 18 (86%) of them, including 3 people with additional urethral trauma. Intraperitoneal trauma was diagnosed in 3 (14%) people. First degree of injury was confirmed in 9 patients (43%), II – 5 people (24%), III – 2 people (10%), IV – 1 person (5%), and in 4 patients (19%) V degree. Bladder injuries were most often a result of a traffic accident (18 people-86%), a small percentage of them were suicide attempts – 2 people (10%), or being crushed by a heavy object – 1 person (5%). Intraperitoneal bladder damage was confirmed in 3 patients (14%) – they were qualified for immediate surgical treatment. Extraperitoneal injuries were reported in 18 patients (86%). These injuries were usually treated conventionaly by keeping the intrabladder catheter for 14 – 21 days and did not require surgical intervention. Patients with III, IV and V stage of injuries required urgent laparotomy with suturing the bladder utilizing absorbable sutures. In four patients (19%) with V level bladder injuries accompanying urethral or ureteral trauma were confirmed. Conclusions: In the assessment of bladder injuries, the AAST scale is effective and has a practical application. Determining the degree of bladder damage allows to optimize effectiveness of the patient’s therapy. Performing a CT scan is the golden standard in the determination of the degree of an injury, often accompanied by urethrocystography.
eISSN:1509-5754
ISSN:0024-0745
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