MP67-19 THE IMPACT OF AN INTERNATIONAL PARTNERSHIP ON THE TREATMENT OF MEN WITH BULBAR URETHRAL STRICTURES AND PELVIC FRACTURE URETHRAL INJURIES (PFUI) IN VIETNAM

Abstract

You have accessJournal of UrologyGlobal Health/Humanitarian (MP67)1 Sep 2021MP67-19 THE IMPACT OF AN INTERNATIONAL PARTNERSHIP ON THE TREATMENT OF MEN WITH BULBAR URETHRAL STRICTURES AND PELVIC FRACTURE URETHRAL INJURIES (PFUI) IN VIETNAM Hung Do, Justin DeGrado, and Joel Gelman Hung DoHung Do More articles by this author , Justin DeGradoJustin DeGrado More articles by this author , and Joel GelmanJoel Gelman More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000002028.19AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: In Vietnam, there is a high incidence of bulbar urethral straddle and pelvic fracture urethral injuries (PFUI) due to the prevalent use of motor bikes for transportation. Urethral strictures have historically been managed with suprapubic tubes, periodic dilation, or 1 or more attempts at urethroplasty that often fail. A United States - Vietnam outreach relationship was established to improve treatment success and decrease the societal burden of urethral stricture disease. We report the impact of this partnership METHODS: A Faculty Urologist at a major Vietnamese teaching hospital (Binh Dan Hospital in HCMC) with an interest in developing expertise in urethroplasty was identified. The Urologist travelled to the United States to receive observational exposure to urethral imaging and surgery. In addition, yearly 2-week trips were established from 2014-present. The initial focus was patient evaluation, urethral imaging (retrograde urethrogram and voiding cystourethrogram), and decision making. This included the first use of flexible cystoscopes in Vietnam. The subsequent focus was operative, mostly anastomotic urethroplasty, with the mentor-mentee. IVUmed provided 2-3 Resident Scholarships for each outreach trip. Binh Dan hospital was provided urethroplasty specific instruments and their first flexible cystoscope. An imaging and follow-up protocol was established which included 4-month cystoscopy to assess outcomes. A database was created to prospectively evaluate success rate over the 2016-2020 study period. RESULTS: Bulbar anastomotic urethroplasty was performed in 97 men. Of the 40 that returned for 4-month cystoscopy, there were 5 recurrences (success rate=87.5%). Posterior urethroplasty for PFUI was performed in 101 men. Of the 74 that returned for 4-month cystoscopy, with 32/74 of those being revision surgery, there were 4 recurrences (success rate=94.6%) with 3 of the 4 failures in re-do cases. With a mean follow-up (defined as time interval between surgery and most recent visit) of 5.0 months (bulbar) and 9.5 months (PFUI), there were no additional recurrences identified, defined as obstructive symptoms or need for intervention. CONCLUSIONS: In Vietnam, the development of an international partnership at a hospital with the necessary infrastructure has been associated with the establishment of a high success rate for bulbar and posterior urethroplasty. Source of Funding: None © 2021 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 206Issue Supplement 3September 2021Page: e517-e517 Advertisement Copyright & Permissions© 2021 by American Urological Association Education and Research, Inc.MetricsAuthor Information Hung Do More articles by this author Justin DeGrado More articles by this author Joel Gelman More articles by this author Expand All Advertisement Loading ...