In the present study, urogenital trauma accounted for 1.1% of admissions to the general surgery department. This rate is lower than those reported to the CNHU HKM by Ouattara et al. [5] and Yevi et al. [6], which were 7% in 2013 and 3% in 2019 respectively. The two previous studies were carried out in urology departments only treating urological lesions. This rate is low because it was calculated in the number of all patients who consulted urgently in a general surgery department taking charge of surgical conditions regardless of the specialty. Lower prevalences have been reported in the sub-region: Kambou et al. [7] in Burkina Faso (0.2%) and Dekou et al. [3] in Togo (0.2%). Today, we are witnessing an increase in cases of urogenital trauma. This is explained by the fact that we are witnessing a modernization of transport infrastructure and means of travel and also by the presence for several years of urologists in the surgery department involving a systematic search for urogenital lesions in all patients received for trauma.

Young adults pay a heavy price for traffic accidents because of their professional occupations involving constant mobility. Our study corroborates this observation given the average age of the patients, which was 31.2 years. Whatever the lesion topography on the urogenital tract, road traffic accidents were the main mechanism for the occurrence of these lesions. Lower average ages were reported by Kambou et al. [2] and Salimi et al. [8] which were 27.1 years and 25 years respectively. This can be explained by the fact that young people constitute the largest and most active part of the population of developing countries; they are generally the most exposed to trauma. Other authors have mentioned that the high-risk activities carried out by men could explain the young age of the injured [9].

Most studies have reported a male predominance [10]. This is the same observation made in our series. Indeed, a male predominance was noted with a sex ratio of 3.2. Two reasons seem to justify this: at the professional level, men are more exposed than women. In addition, the anatomical configuration of the external genital organs makes men more vulnerable to those injuries [2]. The high number of urethral trauma (n = 25) and external genital organs (n = 18) in our study confirms this assertion.

The prevalence of kidney trauma was 21.3% of urogenital trauma in our series and ranks second among urogenital trauma. According to Kambou et al. [2] in Burkina Faso in 2017, kidney trauma ranked first among urogenital trauma with a proportion of 26.1%. This low rate in our series can be explained by the inaccessibility to advanced diagnostic means and therefore benign lesions that go unnoticed. Hematuria or post-traumatic lumbar pains were the indications for imaging exploration in our context. However, any serious trauma patient should benefit from a general exploration including a thoraco-abdomino-pelvic computed tomography [11]. The mechanisms of onset of blunt kidney trauma are dominated by road traffic accidents [11]. In the present series, these accidents occupied the 1st place of the mechanisms of occurrence with 62.6% of the renal traumas. These results are comparable to those of Kane [12] in Dakar who found in his series that road traffic accidents were the leading cause of kidney trauma in 54%. This can be explained by the violence of these traumas which takes into account the two mechanisms namely: the violent direct impact and the renal shock by sudden deceleration. Clinically, lumbar pain (62.5%), macroscopic hematuria (25.0%) and hemodynamic instability (43.7%) were the main clinical signs found in our study. These results corroborate the literature data. Indeed, in Morocco, the same observation was made by Mohamed et al. [13] who reported the same clinical manifestations, namely: lumbar pain, macroscopic hematuria and hemodynamic instability but in different proportions, i.e. respectively 100 %; 72% and 32%. In addition, according to Nash et al. [14], Rosen et al. [15], clinically in major renal trauma, low back pain is most often associated with macroscopic hematuria or signs of shock. This post-traumatic lumbar pain, absent in some patients in our study, can be explained by the fact that it can be masked by other painful lesions located elsewhere in contexts of polytrauma and in the circumstances of coma. The diagnostic means in our study were limited and based only on ultrasound and uroscanner in some cases. Thus, this lesion assessment based on ultrasound and uroscanner showed that most of the patients were classified as minor grades I and II (11 cases) according to the AAST classification, i.e. 68.7% followed by grade IV (03 cases) and grade III (02 cases). Minor kidney injuries are the most frequently encountered in African literature. This predominance does not exclude the absence of serious injuries: on the contrary, our health systems without a medical transport system do not allow the survival of serious injuries during transport from the scene of the accident to the treatment centre. These serious traumas are therefore diagnosed post mortem in our working conditions [13] [15].

Bladder trauma accounted for 17.3% of urogenital trauma recorded in this study. These data are similar to those reported by Kambou et al. in Burkina Faso in 2017 [2] and by Fouelifack et al. in Cameroon in 2021 [7] [16] who found 13% and 13.7% of urogenital trauma respectively. In Benin, Yevi et al. [7] in 2018 reported that bladder trauma accounted for 13.1% of urogenital trauma. The road traffic accident was the most represented mechanism of occurrence with a proportion of 61.5% followed by falls from a height (23.1%). Motor vehicle collisions were the most common mechanism with a proportion of 45% [17].

The prevalence of urethral trauma was 33.3% of urogenital trauma. They occupy the first place of urogenital trauma in our series. The same observation was made by Bobo et al. [18] in Guinea Conakry, and Owon’Abessolo et al. [19] in Cameroon who found that urethral trauma was the most frequent urogenital trauma also with respectively 62, 2% and 45.6%. This first place in our context may be due to the fact that the lesions are obvious and patients are sometimes referred. The most frequent mechanism of occurrence was road traffic accidents with a proportion of 60%. The same observation was made by Bobo et al. [18], Owon’Abessolo et al. [19] and Guirrassy et al. [20].

The incidence of trauma to the external genital organs is probably underestimated. The number of patients with minor lesions who are medically treated by emergency departments and general practitioners, or who do not consult, and who are therefore not included in the series of patients treated in urology departments remains unknown [18]. Trauma of external genital organs accounted for 24.0% of urogenital trauma in our series. In Senegal, Bah et al. [21] reported six cases in four years while Fouelifak et al. [16] reported a 25.4% frequency of urogenital trauma.

Abdominal and craniocerebral traumas were the lesions most often associated with urogenital trauma. These same findings were made by Perrin et al. who found that urogenital trauma was often associated with abdominal and pelvic trauma [22]. Similarly, Salami et al. in Iran [8] and Bariol et al. in Scotland [23] found associated lesions in 73.7% and 51% of cases respectively, demonstrating the frequency of associated lesions during urogenital trauma.

The limitations encountered were of a diagnostic nature. In view of the data in the literature, several diagnostic explorations such as cystoscopy and urography, which provide better diagnostic precision, remain unavailable in our working conditions. Similarly, in a retrospective study, some urological lesions may go unnoticed. Beyond these biases encountered, we believe that the study has good validity and could provide courses of action to improve the management of urogenital trauma