Urethral Disruption Research Articles

The initial management of complete urethral disruption in a deployed military field hospital

BackgroundThe management of male urethral trauma in the multiply injured battle casualty has proved challenging to the deployed military trauma surgeon. Foreign nationals will need culturally sensitive outcomes with adequate urinary function when further surgical management is unlikely to be available in a developing country. For those likely to undergo reconstructive surgery, the early restoration of anatomy is important as it may improve the long-term reconstructive outcome. MethodWe illustrate our technique with a case report and discuss salient points of other patients treated in the same manner, all of whom presented to a role 2 (enhanced) field hospital in Afghanistan with urethral injuries. ResultsA transpelvic high velocity gunshot wounds (HVGSW) was sustained and the patient underwent immediate anatomical re-alignment of the urethra with suture of the bladder neck to the pelvic floor. This case is discussed in detail. ConclusionsComplete disruption of the male urethra can be successfully managed in the field hospital by urethral catheterization at the time of initial surgery. In patients where further reconstruction may not be possible, urethral catheterization provides a culturally permissible solution for patients. In those who may undergo further reconstructive surgery, approximation of the bladder to the pelvic floor may reduce stricture rate in comparison with the suprapubic catheterization alone.

Outcomes of Endoscopic Realignment of Pelvic Fracture Associated Urethral Injuries at a Level 1 Trauma Center

We examined the success of early endoscopic realignment of pelvic fracture associated urethral injury after blunt pelvic trauma. A retrospective review was performed of patients with pelvic fracture associated urethral injury who underwent early endoscopic realignment using a retrograde or retrograde/antegrade approach from 2004 to 2010 at a Level 1 trauma center. Followup consisted of uroflowmetry, post-void residual and cystoscopic evaluation. Failure of early endoscopic realignment was defined as patients requiring urethral dilation, direct vision internal urethrotomy, posterior urethroplasty or self-catheterization after initial urethral catheter removal. A total of 19 consecutive patients (mean age 38 years) with blunt pelvic fracture associated urethral injury underwent early endoscopic realignment. Twelve cases of complete urethral disruption, 4 of incomplete disruption and 3 of indeterminate status were noted. Mean time to realignment was 2 days and mean duration of urethral catheterization after realignment was 53 days. One patient was lost to followup after early endoscopic realignment. Using an intent to treat analysis early endoscopic realignment failed in 15 of 19 patients (78.9%). Mean time to early endoscopic realignment failure after catheter removal was 79 days. The cases of early endoscopic realignment failure were managed with posterior urethroplasty (8), direct vision internal urethrotomy (3) and direct vision internal urethrotomy followed by posterior urethroplasty (3). Mean followup for the 4 patients considered to have undergone successful early endoscopic realignment was 2.1 years. Early endoscopic realignment after blunt pelvic fracture associated urethral injury results in high rates of symptomatic urethral stricture requiring further operative treatment. Close followup after initial catheter removal is warranted, as the mean time to failure after early endoscopic realignment was 79 days in our cohort.

1983 URETHRAL SPARING HISTOTRIPSY OF THE PROSTATE IN A CANINE MODEL

You have accessJournal of UrologyBenign Prostatic Hyperplasia: Surgical Therapy and New Technology I1 Apr 20121983 URETHRAL SPARING HISTOTRIPSY OF THE PROSTATE IN A CANINE MODEL George R. Schade, Timothy L. Hall, and William W. Roberts George R. SchadeGeorge R. Schade Ann Arbor, MI More articles by this author , Timothy L. HallTimothy L. Hall Ann Arbor, MI More articles by this author , and William W. RobertsWilliam W. Roberts Ann Arbor, MI More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2012.02.2143AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Histotripsy is a non-invasive ablative focused ultrasound technology that results in a TURP like defect in a canine model of benign prostatic hypertrophy. However, the necessity of urethral treatment during histotripsy to achieve tissue debulking is unclear. We evaluated the feasibility and healing response to urethral sparing prostate histotripsy. METHODS Histotripsy was performed on 10 mongrel canines using a focused 1 MHz piezoelectric ultrasound transducer targeting the prostatic parenchyma while avoiding the urethra. Cystoscopy was performed immediately post-op (POD0) and on POD3, 7, 14, 28 and 56 to evaluate for evidence of urethral disruption. Ultrasound surveillance was performed preop and at POD7, 14, 28, and 56. Labs, including white blood cell count (WBC) and serum CRP, were checked at the time of surveillance cystoscopy in chronic subjects to monitor for systemic inflammatory response. Four, two, and four subjects were euthanized acutely, at 1 week, and at 8 weeks, respectively, with confirmatory histology. RESULTS Bilateral treatment was possible in 8/10 subjects while left side only treatment was performed in 2/10. Urethral treatment effect was seen in only 1 subject on POD0 post-treatment cystoscopy, which evolved to urethral disintegration by POD14. An additional treatment developed urethral fenestrations at POD28 despite normal appearing cystoscopy for the 1st week. Among 8-week subjects there was a small reduction in volume (20.4 cc at 8 weeks vs. 23.3 cc preop). Lab studies revealed a small transient increase in mean preop WBC compared to POD3 (7.1 vs. 11.7 K/μL) that resolved by POD7. CRP peaked on POD3 and returned to baseline by POD56 (2.3 (preop) vs. 30.3 (POD3) vs. 1.8 (POD56) μg/mL). At 8 weeks, intact treatment cavities contained simple fluid with minimal cellular debris and were completely urothelialized with minimal focal inflammation on histology (see Figure). CONCLUSIONS Urethral sparing histotripsy of the prostate is feasible, resulting in volume reduction with treated volumes appearing as cavities containing simple fluid at 8 weeks. Further studies are needed in humans to evaluate the clinical utility and symptomatic response of urethral sparing. © 2012 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 187Issue 4SApril 2012Page: e800 Advertisement Copyright & Permissions© 2012 by American Urological Association Education and Research, Inc.MetricsAuthor Information George R. Schade Ann Arbor, MI More articles by this author Timothy L. Hall Ann Arbor, MI More articles by this author William W. Roberts Ann Arbor, MI More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...

Repeat Transurethral Manipulation of Bulbar Urethral Strictures is Associated With Increased Stricture Complexity and Prolonged Disease Duration

We examined the association of previous transurethral manipulation with stricture complexity and disease duration among men referred for bulbar urethral reconstruction. We retrospectively reviewed the records of 340 consecutive urethroplasties performed by a single surgeon between July 2007 and October 2010. Only men treated with initial open surgery for bulbar strictures were included in analysis, thus excluding those with hypospadias, lichen sclerosus, pelvic radiation, prior urethroplasty, incomplete data, or pure penile or posterior urethral stenosis. Cases were divided into 2 groups based on the history of transurethral treatment for urethral stricture before urethroplasty, including group 1-0 or 1 and group 2-2 or greater treatments. Of 101 patients with bulbar urethral stricture and all data available 50 and 51 underwent 0 to 1 and 2 or greater previous transurethral treatments, respectively. Repeat transurethral manipulation was strongly associated with longer strictures and the need for complex reconstruction. Repeat transurethral manipulation of bulbar urethral strictures was also associated with an eightfold increase in disease duration between stricture diagnosis and curative urethroplasty. Repeat transurethral manipulation of bulbar strictures is associated with increased stricture complexity and a marked delay to curative urethroplasty.

Fracture penis with urethral disruption & scrotal hematoma: A case report

Penile fracture is a rare condition. Primarily it is a rupture of the corpus cavernosum that occurs when the penis is erect. The rupture can also affect the corpus spongiosum and the urethra. We report a case of a 32 year old man who presented with acute penile pain, peno-scrotal swelling, perineal discoloration and the inability to pass urine after a blunt trauma during sexual intercourse one day back. In emergency surgery we found bilateral partial rupture of the corpus cavernosum with complete urethral and corpus spongiosum disruption. In the one year follow up the patient presented with normal erectile and voiding function.

Fracture penis with urethral disruption & scrotal hematoma: A case report

Fracture penis with urethral disruption & scrotal hematoma: A case report

Complete urethrovesical disruption following obstructed labor

A 22-years-old lady presented with obstructed labor with a probable preoperative diagnosis of bladder/urethral injury. When a laparotomy was performed there was a complete urethral disruption at the vesicourethral junction with a big anterior forniceal tear in the vagina with intact uterus and cervix. The fetus had pushed itself through the upper vagina and bladder neck into the extraperitoneal space leading to complete urethrovesical disruption as a result of prolonged pressure on the vesicourethral junction against pubic symphysis for which an end to end anastomosis was performed. Although trauma has been mentioned as a cause of such urethral disruption in the literature, no such case has been reported so far following obstructed labor. A brief discussion of various surgical options for such cases is discussed.

Comparison of Immediate Primary Repair and Delayed Urethroplasty in Men with Bulbous Urethral Disruption after Blunt Straddle Injury

PurposeThe aim of this study was to analyze the outcomes of immediate primary repair (IPR) compared with delayed repair (DR) after initial suprapubic cystostomy.Materials and MethodsWe reviewed the records of 60 patients with bulbous urethral disruption after blunt trauma from February 2001 to March 2011. Seventeen patients who presented in an acute injury state underwent IPR; 43 patients underwent DR after the initial suprapubic cystostomy. None of the patients had undergone previous urethral manipulation. We compared the outcomes, including stricture, impotence, and incontinence, between the two management approaches. We also measured the time to spontaneous voiding, the duration of suprapubic diversion, and the number of days spent in the hospital.ResultsThe median follow-up was 20.5 months (range, 13 to 59 months; mean, 23.3 months). Among 17 patients in the IPR group, strictures developed in 2 patients (11.7%), and among 53 patients in the DR group, strictures developed in 8 patients (18.6%, p=0.709). The incidences of impotence and incontinence were similar in both groups (17.6% and 0% in the IPR group vs. 27.9% and 4.6% in the DR group, p=0.520 and 1.000, respectively). The time to spontaneous voiding and the duration of suprapubic diversion were significantly shorter in the IPR group (average 27.3 and 33.4 days, respectively) than in the DR group (average 191.6 and 198.1 days, respectively; p<0.001 and <0.001).ConclusionsIPR may provide comparable outcomes to DR and allow for shorter times to spontaneous voiding and reduce the duration of suprapubic diversion.

Tubal Buccal Mucosa Graft without Anastomosis of the Proximal Urethra for Long Segment Posterior Urethral Defect Repair

A 31-year-old man was referred for further management of a urethral stricture. He was a victim of a traffic accident and his urethral injury was associated with a pelvic bone fracture. He had previously undergone a suprapubic cystostomy only owing to his unstable general condition at another hospital. After 3 months of urethral injury, direct urethral anastomosis was attempted, but the surgery failed. An additional 4 failed internal urethrotomies were performed before the patient visited Chungbuk National University Hospital. Preoperative images revealed complete posterior urethral disruption, and the defect length was 4 cm. We performed a buccal mucosa tubal graft without anastomosis of the proximal urethra for a long segment posterior urethral defect. The Foley catheter was removed 3 weeks after the operation and the patient was able to void successfully. After 8 months, he had normal voiding function without urinary incontinence.

Temporary vesicostomy-assisted urethroplasty for recurrent obliterated posterior urethral stricture

We report the outcomes of temporary vesicostomy- assisted anastomotic urethroplasty in patients with recurrent obliterated posterior urethral stricture. A review of the medical records identified 12 men (mean age 35.8 years) who had undergone anastomotic urethroplasty for recurrent obliterated posterior stricture. Preoperative evaluation of the urethral defect included a simultaneous retrograde urethrogram and cystogram. The mean estimated preoperative radiographic length of the urethral disruption was 4.25 cm. All patients underwent 1-stage bulboprostatic anastomotic repair which was assisted by an intraoperative temporary vesicostomy. The initial objective success rate was 83%. The mean follow-up was 22 months. Voiding cystourethrography performed postoperatively demonstrated a wide, patent anastomosis in all but two cases. Urethroscopy performed 1 month after surgery revealed a patent anastomosis with normal urethral mucosa in all but two patients. The mean peak flow rate at the last follow-up visit was 16.3 ml/s. Two patients developed an anastomotic stricture 6 weeks after surgery that was successfully treated by direct visual internal urethrotomy. Finally, all patients had a patent urethra after salvage treatment postoperatively. An open 1-stage temporary vesicostomy- assisted urethroplasty for recurrent obliterated posterior urethral stricture provides satisfactory outcomes and minimal morbidities.

Penile fracture with bilateral rupture in tunica albuginea and complete urethral disruption: A case report with review of literature

Penile fracture is a rare emergent condition, which includes rupture of the tunica albuginea of corpus cavernosum that occurs after trauma to the erect penis. The true incidence of penile fracture is not known as it is rare and under reported entity. Bilateral rupture of tunica albuginea with complete urethral disruption is very rare and very few cases were reported. We report a case of a 46-year-old man who presented with acute pain and swelling of penis and hematuria and severe burning pain during micturition, after a blunt trauma during sexual intercourse. Magnetic resonance imaging (MRI) revealed bilateral rupture in tunica albuginea and complete urethral disruption. We have done emergency repair of tunica and urethra suturing over a catheter. Postoperatively, patient regained normal erectile and voiding functions.

Clinical efficacy of improved vaginal tightening surgery on vaginal relaxation

Objective To explore more effective methods in vaginal tightening surgery for vaginal relaxation treatment. Methods 132 cases of patients who suffered the decline in quality of sex life owing to vaginal relaxation, requiring improved vaginal tightening surgery. The vaginal surgery was performed to repair the muscles and fascia of the anterior and posterior walls effectively, meanwhile the perineal laceration was also repaired. According to the hammock theory of the treatment of urethral disruption, patients with urinary incontinence with tension was treated to strengthen one suture needle on muscle fascia in the middle of urethra, when repairing anterior of vagina. For patients with constipation, the posterior of vagina was repaired to strengthen 3 suture needles on levator ani during repairing the anterior and posterior wall, so that the vaginal mucosa could get maximum protection. Results 118 patients had been followed up for 2-7 years. A questionnaire survey was conducted about four elements targeted on improving sexual satisfaction, tension incontinence, constipation and vaginal discharge. The clinical results were satisfactory. Conclusions The surgical design is professional and highly effective, and the patients are satisfied with the results. It is suitable for experienced specialists to perform the procedures. Key words: Vaginal relaxation; Vaginal tightening surgery

Urethral realignment and simultaneous internal fixation for pelvic fracture associated with posterior urethral disruption

Objective To investigate the outcome of the urethral realignment simultaneous internal fixation in treatment of pelvic fracture associated with posterior urethral disruption. Methods The study included 33 patients with pelvic fracture associated with posterior urethral disruption treated simultaneously by urethral realignment and internal fixation from December 2003 to August 2009. According to AO classification, two patients were with type A2 fracture, six with type B1 ,seven with type B2,five with type B3 ,six with type C1 ,four with type C2 and three with type C3. All the patients were found with complete posterior urethral disruption. Primary urethral realignment combined with emergency open reduction and internal fixation of pelvic fracture were performed in 12 patients. Due to unstable condition, 21 patients underwent primary suprapubic cystostomy and external fixation, sequentially delayed urethral realignment and internal fixation.Results The mean follow-up time of all patients was 37 months ( range, 3-63 months). Of all the patients, 25 patients (76%) regained good without urethral dialation or needed only short term urethral dilatation, and eight patients (24%) suffered from urethral stricture and needed further complex surgery. The incidences of urinary incontinence and erectile dysfunction were 6%(2/33) and 18% (6/33). The erectile dysfunction of two patients was ascribed to sacral nerve injury.At the final follow-up, the mean score was 90.3 points (range, 66-100) according to the Majeed' s scoring system, which showed that the result was excellent in 24 patients, good in eight and fair in one.Conclusions Urethral realignment and simultaneous internal fixation can attain good clinical results for pelvic fracture associated with posterior urethral disruption. It takes advantages of minor surgical trauma,short treatment cycle, good outcome and low complication rate. Key words: Pelvis; Fracture fixation, internal; Urethra; Disruption

Penile fracture with bilateral corporeal rupture and complete urethral disruption: case report and literature review

Penile fracture is a rare injury most commonly sustained during sexual intercourse. We report the case of a 35-year-old man who presented with bilateral rupture of the corpora cavernosa and complete disruption of the urethra. A review of the literature on penile fracture is also presented. Urgent surgical exploration was performed and the injuries repaired primarily. In follow-up, the patient reported satisfactory erectile function. This case highlights the importance of early surgical repair and evaluation for concomitant urethral injuries in cases of penile fracture.

10 OUTCOMES OF ENDOSCOPIC REALIGNMENT OF POSTERIOR URETHRAL INJURIES AT A LEVEL 1 TRAUMA CENTER

You have accessJournal of UrologyTrauma/Reconstruction: Trauma & Reconstructive Surgery1 Apr 201110 OUTCOMES OF ENDOSCOPIC REALIGNMENT OF POSTERIOR URETHRAL INJURIES AT A LEVEL 1 TRAUMA CENTER Laura Leddy, Hunter Wessells, and Bryan Voelzke Laura LeddyLaura Leddy Seattle, WA More articles by this author , Hunter WessellsHunter Wessells Seattle, WA More articles by this author , and Bryan VoelzkeBryan Voelzke Seattle, WA More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2011.02.071AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES We sought to examine the success of initial endoscopic realignment following blunt pelvic trauma. METHODS A retrospective review was performed of all patients with pelvic fracture urethral disruption defect (PFUDD) who underwent endoscopic realignment from 2004–2010 at a Level 1 trauma center. Retrograde urethrogram, flexible cystoscopy, and clinical suspicion aided diagnosis of PFUDD. Endoscopic realignment of the posterior urethra was performed when the patient was clinically stable. Subsequent need for urethral dilation, internal urethrotomy, posterior urethroplasty, or intermittent self-catheterization following urethral catheter removal was considered failure. Uroflowmetry, postvoid residual and cystoscopic evaluation were utilized to diagnose failure of endoscopic realignment. RESULTS Nineteen patients with PFUDD who underwent endoscopic realignment were identified. Mean age was 38 (median 36). Injury etiology included the following: 10 motor vehicle crashes, 4 crush injuries, 3 vehicle vs. pedestrian accidents, 1 snowboarding accident, and 1 motorcycle crash. The following posterior urethral injuries were identified during endoscopic realignment: 12 complete urethral disruptions, 4 incomplete disruptions, 3 unable to determine. Mean time from injury to endoscopic realignment was 2 days (range 0–7 days). Mean duration of urethral catheterization following endoscopic realignment was 53 days (range 12–87 days). Fourteen of 19 patients failed initial endoscopic realignment. One patient was lost to follow up. Mean time to identification of failure following initial urethral catheter removal was 79 days (range 0–288 days). The following interventions were performed among the endoscopic realignment failures: posterior urethroplasty (11) and DVIU (3). Mean follow up for the remaining 4 patients considered to have undergone successful endoscopic realignment is 565 days (range 109–939 days). Findings identified at the time of endoscopic realignment in patients treated successfully with this technique included: complete disruption (2), 2cm dorsal bulbar laceration (1), vertical laceration at bladder neck (1). CONCLUSIONS Primary endoscopic urethral realignment following PFUDD results in high rates of symptomatic urethral stricture requiring further operative treatment. Close follow up after initial catheter removal is warranted. © 2011 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 185Issue 4SApril 2011Page: e4 Advertisement Copyright & Permissions© 2011 by American Urological Association Education and Research, Inc.MetricsAuthor Information Laura Leddy Seattle, WA More articles by this author Hunter Wessells Seattle, WA More articles by this author Bryan Voelzke Seattle, WA More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...

Genitourinary system trauma after 2003 Bam earthquake in Kerman, Iran

Background:Natural disasters, especially earthquakes, result in many health problems all over the world, of which urological injuries should not be underestimated. Car accidents and falling from a height are the most common causes of genitourinary system injury. The lack of specific data in the literature regarding the outcome of earthquake-related genitourinary system trauma prompted us to undertake this study.Methods:We retrospectively evaluated the genitourinary system injury in patients who had survived the Bam earthquake. In this study, all patients admitted to two main back-up hospitals of Kerman were included. Of 256 patients who had been referred to Kerman hospitals, 28 cases were found to have urologic damage on physical examination, intravenous pyelography, abdominopelvic X-ray, and ultrasonography.Results:Of 28 patients with urologic damage, 22 (78.5%) were male and six (21.5%) were female. Their age ranged from 18 to 65 years. The injures included urethral disruption in 21 cases (75.5%), vesicovaginal fistula in four cases (14%), kidney rupture in two cases (7%) and bladder neck disruption accompanied with total right ureteral disruption and vesicovaginal fistula in a female patient (3.5%).Conclusion:We have evaluated the incidence of genitourinary injuries after an earthquake disaster for the first time. The most and least common urologic injury in our patients was urethral disruption and ureteral injury, respectively.

Grafts are Unnecessary for Proximal Bulbar Reconstruction

We compared our experience with the reconstruction of proximal vs distal bulbar stricture to assess the role of excision and primary anastomosis vs graft procedures at each site. We reviewed all urethroplasties done by a single surgeon during a 2-year period. Data analyzed included patient history and demographics, operative details, stricture length and site, and clinical outcome. The proximal bulbar urethra was defined as the segment within 5 cm of the membranous urethra and the distal bulb was defined as the adjoining segment extending to the penoscrotal junction. Cases involving the pendulous or posterior urethra were excluded from study. Of 210 urethroplasties from 2007 to 2009, 112 were done for bulbar strictures, including 72 (64%) for proximal bulbar strictures. All 72 cases were treated with excision and primary anastomosis. Median stricture length was 2 cm (range 1 to 5), although 31 of 72 strictures (43%) were of intermediate length (2.5 to 5 cm). Recurrence developed in 1 case (1.4%). Distal bulbar strictures in 40 of the 112 cases (36%) were treated predominantly with substitution urethroplasty in 36 (90%), and with excision and primary anastomosis in 4 (10%). Median stricture length was 3.75 cm (range 1.5 to 20). We noted intermediate length stricture in 18 of 40 cases (45%) and recurrence in 11 (28%). Of intermediate length strictures recurrence was much rarer after excision and primary anastomosis than after graft procedures (1 of 33 or 3.0% vs 6 of 16 or 38%, p<0.05). Location is critical when selecting an appropriate technique for bulbar urethral reconstruction. Excision and primary anastomosis are superior to grafts in the proximal bulb. Grafts are often unnecessary for reconstructing proximal bulbar strictures 5 cm or less.

Long-Term Results of Early Endoscopic Realignment of Complete Posterior Urethral Disruption

To assess the long-term outcome of early endoscopic realignment (EER) of complete posterior urethral disruption. The study included 11 consecutive patients with complete posterior urethral disruption secondary to a road accident (n = 9) or a falling impact (n = 2). EER was performed using a simultaneous endoscopic transvesical and transurethral approach under fluoroscopic guidance. An 18F Foley urethral catheter was left for 4 weeks. All patients were evaluated postoperatively for incontinence, erectile dysfunction, and urethral strictures. The patients' mean age was 32 years (range 20-62 y). The mean duration of the realignment procedure was 40 minutes (range 30-60 min), and it was performed within an average of 48 hours (range 3-72 h) from hospitalization. Efficient erection was maintained in five (45%) patients, and incontinence did not develop in any patient. Five (45%) patients in whom urethral strictures developed were treated initially by endoscopic urethrotomy (EU), which was successful in one patient. Three of the four in the EU failure group remained on periodic urethral dilation, refusing to undergo urethroplasty, and one patient with interposition of a pubic bone fragment underwent successful urethroplasty. There were no other complications during a mean follow-up of 4.3 years (range 2-7 y). EER is a valuable alternative to long-term suprapubic drainage and delayed urethroplasty. Realignment failure did not interfere with the results of open urethroplasty. A further search for prognostic factors should improve the selection of patients for the early or the delayed approach.

Clinical comparison of flexible endoscopic realignment with traditional open realignment

To evaluate the clinical value of flexible endoscopic realignment for posterior urethral disruption as compared with traditional open realignment. A total of 58 patients suffering posterior urethral disruption in Beijing Jishuitan Hospital from January 2003 to May 2009 were examined. Twenty-three patients (Group A) were performed with flexible endoscopic realignment and 35 patients (Group B) were performed with traditional open realignment. The operation duration and post-operative complications were compared between two groups. All operations were successfully performed. The operative duration was significantly shorter in Group A than that in Group B [(29 +/- 10) min vs (58 +/- 11) min, P = 0.000]. Also, the patients in Group A had a significantly decreased rate of stricture and false urethral passages formation (17.4% vs 42.9%, 0 vs 20%, both P < 0.05). There were no significant difference in urinary infection, repeat procedures, incontinence and impotence between two groups (P > 0.05). As compared with traditional open realignment, flexible endoscopic realignment has the advantages of short operation duration, lesser trauma and fewer complications. Therefore it is an excellent method for the treatment of urethral injury.

Case Report Posterior urethral disruption in 12 year old boy with late urethroplasty after multi-organ injury

Case Report Posterior urethral disruption in 12 year old boy with late urethroplasty after multi-organ injury