Early Primary Endoscopic Realignment of Posterior Urethral Injury- Evaluation and Follow-Up
Journal Title: Journal of Krishna Institute of Medical Sciences University - Year 2013, Vol 2, Issue 2
Abstract
Background: The management of complete orpartial posterior urethral disruption is controversialand much debate continues regarding theimmediate, early and delayed definitive therapy.Objective: We report our institutional experienceand long term result of early endoscopicrealignment of traumatic posterior urethral injury.Method and Materials: Between September1996 and March 2012, ninety six men witheither complete (84) or partial (12) posteriorurethral injury secondary to blunt trauma (11)or pelvic fractures (85), presented to our institutionand these patients underwent immediatesuprapubic cystostomy followed by early primaryendoscopic realignment done 3-8 daysafter injury. Result: Seventy four patients(92.5%) were continent after catheter removal.Urethral stricture was seen in seventy two patients(90%) of which fifty patients (69.4%)had simple urethral stricture who were managedby urethral dilatation on outpatient basis. Fourteenpatients (19.4%) developed short strictureswhich were successfully treated with visualinternal urethrotomy. Eight patients(11.1%) required anastomotic urethroplasty fordense stricture. Potency was retained in seventyfive patients (93.75%). Urinary flow measurementsat follow-up evaluation were satisfactory.Conclusion: Early primary endoscopic realignmentin our experience reduces time to spontaneousvoiding, decrease the need for majorreconstructive surgery and long term supra publicurinary diversion.
Authors and Affiliations
Prasad Mylarappa , Puvvada Sandeep , Prathvi , Kailash B Banale , Amey , Amith , D. Ramesh
Keywords
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