title: [Endourological re-establishment by transluminal puncture for a complete obliteration of traumatic urethral disruption].
abstract: We performed transluminal re-canalization by needle puncture under fluoro-endoscopic control on a total of ten patients (membranous urethra, 8; bulbous urethra, 2) with complete obliteration after traumatic urethral disruption. The re-canalized tract was created by balloon dilation, internal urethrotomy or endoscopic resection of the scar tissue. The patient age ranged from 10 to 57 years (mean age; 37.9 +/- 15.3 years). A transluminal puncture was attempted in three patients by transperineal-transurethral approach and in seven by transurethral approach. In one of them, who sustained a complete membranous disruption 5 weeks ago, transluminal puncture failed because of the movable proximal urethra. The remaining nine patients voided without difficulty for the mean follow-up period of 18.1 +/- 14.3 months (range: 2-46). Three patients had mild stress urinary incontinence. A transluminal puncture is less invasive, safe and reliable for re-establishment of the true proximal part of the disrupted urethra. It can be recommended as a useful technique for endo-urological re-establishment for a completely obliterated urethra. Although this endoscopic re-establishment requires urethral sounding or internal urethrotomy for 6 months postoperatively, it may be an alternative to conventional surgical repair.
authors.affiliation: Department of Urology, Gifu Prefectural Hospital.
authors.forename: T
authors.initials: T
authors.lastname: Takeuchi
authors.forename: S
authors.initials: S
authors.lastname: Ishihara
authors.forename: Y
authors.initials: Y
authors.lastname: Nagatani
authors.forename: T
authors.initials: T
authors.lastname: Koide
authors.forename: S
authors.initials: S
authors.lastname: Sakai
authors.forename: M
authors.initials: M
authors.lastname: Tamaki
authors.forename: S
authors.initials: S
authors.lastname: Maeda
authors.forename: N
authors.initials: N
authors.lastname: Yamamoto
authors.forename: S
authors.initials: S
authors.lastname: Kobayashi
authors.forename: Y
authors.initials: Y
authors.lastname: Kawada
mesh_terms: D000293:Adolescent; D000328:Adult; D002404:Catheterization; D002648:Child; D004724:Endoscopy; D006801:Humans; D008875:Middle Aged; D011677:Punctures; D014521:Urethra / Q000293:injuries* / Q000601:surgery*; D014524:Urethral Obstruction / Q000209:etiology / Q000601:surgery*