Firework-related genitourinary trauma: a single institution case series

Int Urol Nephrol. 2020 Sep;52(9):1617-1623. doi: 10.1007/s11255-020-02464-4. Epub 2020 Apr 17.

Abstract

Purpose: The clinical impact of firework-related genitourinary trauma remains unknown. In this study, we aim to characterize injury patterns, interventions, and clinical outcomes of firework-related genitourinary injuries and evaluate the relationship with certain firework types.

Methods: A retrospective case series was conducted for patients treated at a level I trauma center from 2005 to 2019 who experienced firework-related genitourinary trauma. Fifteen patients sustained firework-related genitourinary injuries. Injury patterns, operative interventions, clinical outcomes, as well as details of firework type were examined.

Results: Firework-related genitourinary injuries were identified in 15 trauma patients. Mean age was 29.7 years (± 14.3, standard deviation), all (100%) patients were male, and most (11; 73.3%) were Caucasian. Average length of stay (LOS) was 10.5 days, and 4 (26.7%) patients required ICU admission. Ten (66.7%) patients underwent 28 operative interventions (mean 1.9 per patient), 7 (46.7%) of whom underwent 15 urologic specific intervention (mean 1.0 per patient). No injury-related deaths occurred. Considering firework type, 10 (66.7%) patients had mortar or shell-related injuries, while 3 (20.0%) involved firecrackers, and 2 (13.3%) involved bottle rockets. All (100%) patients sustained injuries that occurred with the use of legally obtained fireworks and 11 (73.3%) were active users.

Conclusions: Firework-related genitourinary injuries occurred most frequently in young men, lead to polytrauma with the scrotum and penis being the most common urologic sites, had high operative rates, and were most commonly associated with legally obtained fireworks, specifically mortar and shell fireworks. Further investigation is needed to understand the long-term sequelae of these injuries.

Keywords: Explosive; Firework; Genitourinary; Trauma.