Pelvic and Genital Trauma

Trauma to Genitals

- Rarely life threatening

- Quite pain and emotional

Trauma to Pelvis

- Can be life threatening

- Difficult to assess due to muscle and fat hips, buttocks, thighs

Pelvic Anatomy

- Most painful thing might not be most important

- Cauda equina

- Fused spinal column

- Internal organs (rectum, bladder) and genitals (penis, testis, vagina, cervix)

Pelvic Fracture

- Large marrow cavities and pelvic ring

- Vascularization of bone and surrounding blood vessels can bleed leading to shock

Assessment of Genital Trauma

- MOI

- Do not discount internal injury due to patient focusing on genital trauma (only 1%)

- Pain, bruising, obvious bleeding, internal bleeding

- Bleeding from urinary tract or rectum

Assessment of Pelvic Trauma

- Instability of pelvic ring

- Shortening/rotation of leg

- Patient keeps leg bent for comfort

- Shock, may be slow to show

Treatment of Pelvic and Genital Trauma

- Treat open wounds

- Use pelvic sling

- Anticipate shock (need OR)

- Notify OR and monitor for any changes