Early Primary Endoscopic Realignment of Posterior Urethral Injury-Evaluation and Follow-Up.

摘要

Background: The management of complete orpartial posterior urethral disruption is contro-versial and much debate continues regarding theimmediate, early and delayed definitive therapy.Objective: We report our institutional experi-ence and long term result of early endoscopicrealignment of traumatic posterior urethral in-jury. Method and Materials: Between Septem-ber 1996 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 insti-tution and these patients underwent immediatesuprapubic cystostomy followed by early pri-mary endoscopic realignment done 3-8 daysafter injury. Result: Seventy four patients(92.5%) were continent after catheter removal.Urethral stricture was seen in seventy two pa-tients (90%) of which fifty patients (69.4%)had simple urethral stricture who were managedby urethral dilatation on outpatient basis. Four-teen patients (19.4%) developed short stric-tures which were successfully treated with vi-sual internal urethrotomy. Eight patients(11.1%) required anastomotic urethroplasty fordense stricture. Potency was retained in sev-enty five patients (93.75%). Urinary flow mea-surements at follow-up evaluation were satis-factory.Conclusion: Early primary endoscopic realign-ment in our experience reduces time to spon-taneous voiding, decrease the need for majorreconstructive surgery and long term supra pub-lic urinary diversion.