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Abstract

In this study, it was clear that the patients who underwent urethroplasty for the first time showed good results. However, there has been evidence of poor results in patients undergoing urethroplasty after realignment or urethroplasty. In case of realignment, this could be either because of adverse effect of the procedure itself or severe primary urethral injury, which may explain the failure of realignment as well as subsequent urethroplasty. Realignment can worsen the injury in many ways. First, it may physically exaggerate the urethral injury. 1 Mundy A.R. Pelvic fracture injuries of the posterior urethra. World J Urol. 1999; 17: 90-95 Crossref Scopus (50) Google Scholar , 2 Mundy A.R. Reconstruction of the urethra after pelvic trauma. Acta Urol Belg. 1998; 66: 48 Google Scholar This may be especially true when realignment is done in suboptimal conditions (without flexible cystoscopy and expertise, overzealous multiple attempts) or in an early phase when traumatized urethral margins are edematous, friable, and ischemic. Second, putting the catheter across the urethral margins will prevent the free drainage of resolving hematoma and inflammatory exudate, which is present near traumatized urethral ends and would have otherwise gradually drained through either of the urethral ends. This will cause more inflammatory injury and fibrosis. Third, there is a risk of introducing an infection into the hematoma by realignment. Editorial CommentUrologyVol. 75Issue 1PreviewThis manuscript addresses the following question: “do prior urethral manipulations adversely affect the outcomes of urethral reconstruction, for traumatic posterior urethral strictures?” This question is of some importance as it relates to 2 issues, should these patients be treated in the acute phase with primary catheter realignment as has been suggested in recent years? And who should perform urethral reconstruction in these patients with posterior urethral traumatic strictures? The manuscript is based on a relatively small group of patients (58 patients during 13 years); thus, the study may not be robustly powered to make strong negative statements where statistical significance has not been reached. Full-Text PDF Impact of Prior Urethral Manipulation on Outcome of Anastomotic Urethroplasty for Post-traumatic Urethral StrictureUrologyVol. 75Issue 1PreviewTo determine the impact of earlier urethral interventions on the outcomes of anastomotic urethroplasty in post-traumatic stricture urethra. Full-Text PDF