Equine-Related Genitourinary Injuries in Rural Oklahoma: A 10-Year Experience

Equine-Related Genitourinary Injuries in Rural Oklahoma: A 10-Year Experience | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Equine-Related Genitourinary Injuries in Rural Oklahoma: A 10-Year Experience James Charles, Vsevolod Shurkhay, Jianqiang Huo, Elvis Tamo Achu, and 5 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-8960241/v1 This work is licensed under a CC BY 4.0 License Status: Under Review Version 1 posted 7 You are reading this latest preprint version Abstract Purpose Equine-related injuries are a significant yet under-researched cause of trauma in rural areas, particularly in high-equine-density states like Oklahoma, where horseback riding is a key part of both livelihood and recreation. This study examines patterns, severity, and outcomes over a 10-year period, with a new focus on genitourinary trauma in a rural trauma center group. Methods This retrospective cohort study included all patients admitted to a Level II trauma center in Tulsa, Oklahoma, with equine-related injuries from May 2015 to December 2025 (n = 259). Data were collected from the trauma registry, covering demographics, mechanisms, injury locations (grouped as brain/craniofacial, chest, spinal, genitourinary, etc.), Injury Severity Score (ISS), length of stay (LOS), and mortality. Severe injuries were defined as ISS > 15. Comparisons used Fisher’s exact test and the Mann-Whitney U test (p < 0.05 considered significant). The study was approved as non-human-subjects research by the institutional review board. Results The mean age was 48.0 years (SD 17.5); 56.0% were male. The average ISS was 9.1 (SD 6.0), with 12.4% classified as severe cases. Common injury mechanisms included falls from a horse (44.8%) and being struck by a horse (32.8%). The most common injury locations were brain/craniofacial (35.5%), chest (28.2%), and spinal (25.1%). Severe injuries were more frequently associated with brain/craniofacial injuries (75.0% vs 30.0%, p < 0.001), chest injuries (46.9% vs 25.6%, p = 0.01), and kidney involvement (12.5% vs 1.8%, p = 0.01). Genitourinary injuries—including kidney, ureter, bladder, penis, and scrotum—made up approximately 9.3% of cases, mainly in severe trauma. The median length of stay was 2.0 days, longer in severe cases (p < 0.001); mortality rate was 1.5%, all related to TBI. Conclusions In rural Oklahoma, equine-related trauma often involves head and torso injuries, with genitourinary problems emerging as a significant severe subset in this occupational and recreational setting. Findings emphasize the need for targeted rural prevention strategies, including mandatory helmet use and education on the risks of direct horse contact. Equine-related injuries genitourinary injuries horseback riding injury prevention Full Text Additional Declarations No competing interests reported. Cite Share Download PDF Status: Under Review Version 1 posted Editorial decision: Revision requested 06 May, 2026 Reviews received at journal 16 Mar, 2026 Reviewers agreed at journal 26 Feb, 2026 Reviewers invited by journal 26 Feb, 2026 Editor assigned by journal 25 Feb, 2026 Submission checks completed at journal 25 Feb, 2026 First submitted to journal 24 Feb, 2026 You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-8960241","acceptedTermsAndConditions":true,"allowDirectSubmit":false,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":597766123,"identity":"7f012ce5-5ff5-42fc-b19c-d6644bb2433f","order_by":0,"name":"James Charles","email":"","orcid":"","institution":"Louisiana State University Health Science Center","correspondingAuthor":false,"prefix":"","firstName":"James","middleName":"","lastName":"Charles","suffix":""},{"id":597766124,"identity":"8ecbf6f5-81e2-448a-8598-513818c2d3cf","order_by":1,"name":"Vsevolod 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Hybrid","inReviewEnabled":true,"inReviewRevisionsEnabled":false},"keywords":"Equine-related injuries, genitourinary injuries, horseback riding, injury prevention","lastPublishedDoi":"10.21203/rs.3.rs-8960241/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-8960241/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003ch2\u003ePurpose\u003c/h2\u003e \u003cp\u003eEquine-related injuries are a significant yet under-researched cause of trauma in rural areas, particularly in high-equine-density states like Oklahoma, where horseback riding is a key part of both livelihood and recreation. This study examines patterns, severity, and outcomes over a 10-year period, with a new focus on genitourinary trauma in a rural trauma center group.\u003c/p\u003e\u003ch2\u003eMethods\u003c/h2\u003e \u003cp\u003eThis retrospective cohort study included all patients admitted to a Level II trauma center in Tulsa, Oklahoma, with equine-related injuries from May 2015 to December 2025 (n\u0026thinsp;=\u0026thinsp;259). Data were collected from the trauma registry, covering demographics, mechanisms, injury locations (grouped as brain/craniofacial, chest, spinal, genitourinary, etc.), Injury Severity Score (ISS), length of stay (LOS), and mortality. Severe injuries were defined as ISS\u0026thinsp;\u0026gt;\u0026thinsp;15. Comparisons used Fisher\u0026rsquo;s exact test and the Mann-Whitney U test (p\u0026thinsp;\u0026lt;\u0026thinsp;0.05 considered significant). The study was approved as non-human-subjects research by the institutional review board.\u003c/p\u003e\u003ch2\u003eResults\u003c/h2\u003e \u003cp\u003eThe mean age was 48.0 years (SD 17.5); 56.0% were male. The average ISS was 9.1 (SD 6.0), with 12.4% classified as severe cases. Common injury mechanisms included falls from a horse (44.8%) and being struck by a horse (32.8%). The most common injury locations were brain/craniofacial (35.5%), chest (28.2%), and spinal (25.1%). Severe injuries were more frequently associated with brain/craniofacial injuries (75.0% vs 30.0%, p\u0026thinsp;\u0026lt;\u0026thinsp;0.001), chest injuries (46.9% vs 25.6%, p\u0026thinsp;=\u0026thinsp;0.01), and kidney involvement (12.5% vs 1.8%, p\u0026thinsp;=\u0026thinsp;0.01). Genitourinary injuries\u0026mdash;including kidney, ureter, bladder, penis, and scrotum\u0026mdash;made up approximately 9.3% of cases, mainly in severe trauma. The median length of stay was 2.0 days, longer in severe cases (p\u0026thinsp;\u0026lt;\u0026thinsp;0.001); mortality rate was 1.5%, all related to TBI.\u003c/p\u003e\u003ch2\u003eConclusions\u003c/h2\u003e \u003cp\u003eIn rural Oklahoma, equine-related trauma often involves head and torso injuries, with genitourinary problems emerging as a significant severe subset in this occupational and recreational setting. Findings emphasize the need for targeted rural prevention strategies, including mandatory helmet use and education on the risks of direct horse contact.\u003c/p\u003e","manuscriptTitle":"Equine-Related Genitourinary Injuries in Rural Oklahoma: A 10-Year Experience","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2026-03-03 19:54:25","doi":"10.21203/rs.3.rs-8960241/v1","editorialEvents":[{"type":"communityComments","content":0},{"type":"decision","content":"Revision requested","date":"2026-05-06T12:41:57+00:00","index":"","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2026-03-16T11:07:03+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"102442237485044880120493594991167003090","date":"2026-02-26T20:25:29+00:00","index":"hide","fulltext":""},{"type":"reviewersInvited","content":"","date":"2026-02-26T16:06:40+00:00","index":"","fulltext":""},{"type":"editorAssigned","content":"","date":"2026-02-26T02:36:28+00:00","index":"","fulltext":""},{"type":"checksComplete","content":"","date":"2026-02-25T16:36:34+00:00","index":"","fulltext":""},{"type":"submitted","content":"World Journal of Urology","date":"2026-02-24T18:17:43+00:00","index":"","fulltext":""}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"world-journal-of-urology","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"wjur","sideBox":"Learn more about [World Journal of Urology](https://link.springer.com/journal/345)","snPcode":"345","submissionUrl":"https://submission.nature.com/new-submission/345/3","title":"World Journal of Urology","twitterHandle":"","acdcEnabled":true,"dfaEnabled":true,"editorialSystem":"stoa","reportingPortfolio":"Springer Hybrid","inReviewEnabled":true,"inReviewRevisionsEnabled":false}}],"origin":"","ownerIdentity":"eef8f39d-5060-47b2-bb1b-4ebea7b44c80","owner":[],"postedDate":"March 3rd, 2026","published":true,"recentEditorialEvents":[{"type":"decision","content":"Revision requested","date":"2026-05-06T12:41:57+00:00","index":"","fulltext":""}],"rejectedJournal":[],"revision":"","amendment":"","status":"under-review","subjectAreas":[],"tags":[],"updatedAt":"2026-05-18T08:55:47+00:00","versionOfRecord":[],"versionCreatedAt":"2026-03-03 19:54:25","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-8960241","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-8960241","identity":"rs-8960241","version":["v1"]},"buildId":"XKTyCvWXoU3ODBz1xrDgd","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}