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ORIGINAL ARTICLE
Year : 2013  |  Volume : 29  |  Issue : 3  |  Page : 188-192

Evaluation of early endoscopic realignment of post-traumatic complete posterior urethral rupture


Department of Urology, Faculty of Medicine, Assiut University, Assiut, Egypt

Correspondence Address:
Ehab O ElGanainy
Department of Urology, Assiut University Hospital, Faculty of Medicine, Assiut University, Assiut, 71111
Egypt
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0970-1591.117281

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Introduction: to report our experience with 41 patients treated by early endoscopic realignment of complete post-traumatic rupture urethra. Materials and Methods: The study includes patients presented to our institute, between May 2004 and April 2009, with post-traumatic complete posterior urethral disruption. Preoperative retrograde urethrography, voiding cystourethrography and abdominopelvic CT were performed to evaluate the urethral defect length, the bladder neck competence, the prostate position, and the extent of the pelvic hematoma. Within the first week after trauma, antegrade and retrograde urethroscopy were performed to identify both urethral ends and insert urethral catheter. Patients were followed up by pericatheter retrograde urethrogram monthly postoperatively till catheter removal on disappearance of extravasation. Retrograde urethrography, voiding cystourethrography and urethroscopy were performed 1 month after the removal of the catheter. Follow-up abdominal ultrasound and uroflowmetry monthly till 6 months, bimonthly till 1 year, and every 3 months thereafter were encouraged. Urinary continence and postoperative erectile dysfunction were assessed by direct patient interview. Results: Forty one patients in the age group 17-61 years (mean 37.9) were treated. Patients were followed up for 12-36 months (mean 17 months). Complete healing of the urethra occurred in 18 patients (43.9%). Passable urethral stricture developed in 15 patients (36.6%). Complete urethral obstruction occurred in eight patients (19.5%). Conclusions: Early endoscopic realignment for complete posterior urethral rupture is a feasible technique with no or minimal intraoperative complications. The technique is successful as the definitive line of therapy in reasonable number of patients and seems to render further future interventions for inevitable urethral stricture easier.


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