[Endourological re-establishment by transluminal puncture for a complete obliteration of traumatic urethral disruption].
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.
Takeuchi
T
T
Department of Urology, Gifu Prefectural Hospital.
Ishihara
S
S
Nagatani
Y
Y
Koide
T
T
Sakai
S
S
Tamaki
M
M
Maeda
S
S
Yamamoto
N
N
Kobayashi
S
S
Kawada
Y
Y
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*