Management of posttraumatic posterior urethral disruption.
We reviewed our experience with 17 cases of posterior urethral disruption due to traumatic pelvic injuries. In all cases, a suprapubic cystostomy was performed at first. For blunt injuries, urethroplasty was delayed for 6 months in average. For most of the penetrating injuries (3/4), we performed immediate debridement and primary repair. Resulting bulbous or membranous strictures less than 3 cm long were treated with one-stage perineal excision-reanastomosis urethroplasty. Membranous strictures longer than 3 cm were managed with a combined transpubic-perineal repair, while bulbous defects longer than 3 cm were treated with a scrotal pedicled island flap. The overall restricture rate was 25%. Those having had initial repeated urethrotomies displayed a 100% restenosis rate. Incontinence rate was 12.5% Erectile dysfunction occurring in 42% of our patients is a sequela of the pelvic injury and was found to be directly related postoperatively to its presence at the time of surgery.
Chalouhy
E
E
Urology Department, Hôtel-Dieu de France Hospital, Beirut, Lebanon.
Jabbour
M
M
Armache
K
K
Kassardjian
Z
Z
Moukarzel
M
M
el-Khoury
R
R
Chaiban
R
R
Merhej
S
S
D000063:Accidents, Traffic; D000293:Adolescent; D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010388:Pelvis / Q000293:injuries*; D014521:Urethra / Q000293:injuries* / Q000601:surgery*; D014525:Urethral Stricture / Q000601:surgery; D014948:Wounds, Gunshot / Q000150:complications; D014949:Wounds, Nonpenetrating / Q000150:complications