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Objective
- To describe the epidemiology of genitourinary (GU) injury from toilets that present to USA Emergency rooms (ERs).
BJU International
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Paediatrics
No small slam: increasing incidents of genitourinary injury from toilets and toilet seats
Correspondence: Benjamin N. Breyer, Department of Urology, UCSF, 400 Parnassus Ave Suite A-610, Box 0738, San Francisco, CA 94143-0738, USA.
e-mail: bbreyer@urology.ucsf.edu
Abstract
Materials and Methods
- The National Electronic Injury Surveillance System (NEISS) is a stratified probability sample of hospital ER visits for USA consumer product-related injuries.
- NEISS was used to estimate total toilet- and toilet seat-related GU injury for the years 2002–2010, as well as to describe demographics and injury characteristics.
- Analyses were performed using strata, primary sampling units and sample weights to accommodate the complex sample survey design.
- Data are reported as national estimates with 95% confidence intervals (CIs) provided.
Results
- In all, 13 175 (95% CI 10 185–16 165) GU injuries related to toilets presented to ERs during 2002–2010.
- The most common mechanism involved crush from accidental fall of toilet seat, described in 9011 (68.4%, 95% CI 6907–11 115) cases.
- Most crush injuries were isolated to the penis (98.1%). Of crush injuries, 81.7% occurred in children aged 2–3 years and 99.3% occurred in the home. Crush injuries increased over the period 2002–2010 (P = 0.017) by ≈100 per year, ending with an estimated 1707 (95% CI 1011–2402) by 2010.
- Most patients who sustained toilet- and toilet seat-related GU injuries were treated in the ER and then discharged.
Conclusion
- While penile crush injury related to a toilet seat is an uncommon mechanism of urological injury in children, the number of incidents appears to be rising.
- These findings support educational efforts and interventions, such as exchange of heavy toilet seats with slow-close toilet seat technology.