Signs of genitourinary and / or gynecologic (usually vaginal) injuries include Blood at the urethral meatus Scrotal or perineal hematoma Hematuria Anuria A high-riding prostate Vaginal bleeding Intestinal or rectal injuries can cause Abdominal or pelvic pain Rectal bleeding Later development of peritonitis Neurologic injuries can cause Weakness or loss of sensation and reflexes in the lower extremities, rectum, or perineum Incontinence Urinary retention Mortality rate is high when fractures are unstable or posterior or when they cause hemorrhagic shock.