Primary endoscopic realignment following posterior urethral disruption.
We describe 5 cases in which complete posterior urethral disruption associated with pelvic fracture was managed by primary endoscopic realignment 7 to 19 days after injury. Realignment was accomplished using a flexible endoscope through the suprapubic tract and a rigid or flexible cystoscope in the distal urethra. A guide wire was passed from the suprapubic tract through the disrupted membranous urethra and out the distal urethra. A Councill catheter was left indwelling for 5 to 10 weeks. After removal a program of intermittent self-catheterization was continued for 3 months. Excellent results were obtained in 4 patients who are continent, including 2 who are potent. This technique allows considerable reduction of patient morbidity without compromising formal urethroplasty should it later be required.
Cohen
J K
JK
Division of Urology, Allegheny Campus Medical College of Pennsylvania, Pittsburgh.
Berg
G
G
Carl
G H
GH
Diamond
D D
DD
D000062:Accidents, Occupational; D000063:Accidents, Traffic; D000293:Adolescent; D000328:Adult; D004724:Endoscopy; D050723:Fractures, Bone / Q000150:complications; D006801:Humans; D008297:Male; D008722:Methods; D010384:Pelvic Bones / Q000293:injuries; D014521:Urethra / Q000293:injuries*; D014546:Urinary Catheterization; D014947:Wounds and Injuries / Q000628:therapy