The Epidemiology of Genitourinary Self-Inflicted Injuries: Analysis of the National Trauma Databank.

Objectives: To provide insight into the epidemiologic characteristics and trends of genitourinary (GU) self-inflicted injury (SII).

Methods: We used data from the National Trauma Databank between 2017-2020. We described the characteristics of GU SII cases based on injured organ and then compared male and female injuries.

Results: We identified 56,463 patients with SII, of which 1,508 (2.7%) had GU involvement. Most cases were male patients (77.3%) and white (70.6%). Median age was 35 years (IQR 26 - 50). The most commonly injured GU organs was kidney (43.4%), followed by scrotum / testes (22.5%), and penis (18.2%). Most cases (89.9%) represented a single-organ injury whereas 10.1% had two or more GU organs injured. Seventy-three of those with kidney injuries (11.2%) underwent nephrectomy. Only one patient performing GU SII had a diagnosis code for transsexualism but the majority (82.2%) suffered from pre-existing conditions of which 20.5% had three or more comorbidities. More than half the population (54.9%) had preexisting diagnosed mental or personality disorder. A non-GU co-injury was present in most cases (70.8%), most commonly affecting another abdominal organ (44.3%) or fractures (41.3%). A positive drug screen was found in 30.7% of cases. Most patients survived though 15.4% died. 94% of fatal cases had a concomitant non-GU injury.

Conclusions: GU injuries account for 2.6% of all SII. These patients are often young white males with known mental or personality disorders. Kidneys were most common injuried and mortality was highest in cases of kidney and bladder injuries with multi-organ trauma involving non-GU organs.