Endoscopic management of a traumatic disruption of the bulbous urethra using a thin trocar puncture.
A case is reported in which complete disruption of the bulbous urethra resulted in a straddled-type injury, which was managed by endoscopic realignment with a thin trocar needle. The endoscopic urethroplasty consisted of: (i) direct observation of the proximal end of the obliterated urethra by an antegrade flexible cystoscope; (ii) adjustment of the direction of trocar penetration under fluoroscopy and direct vision; (iii) confirmation of the exact trocar position and penetration by antegrade flexible cystoscope; and (iv) placement of the guidewire following the trocar penetration as guidance for urethrotomy. A Foley catheter was left in place for 6 weeks. To date, no further endoscopic revision has been required. Although long-term follow up and more experience are required, this technique is reported because it appears to be safe, reproducible, simple and minimally invasive.
Nakajima
K
K
First Department of Urology, Toho University School of Medicine, Tokyo, Japan. grandam@mba.sphere.ne.jp
Deguchi
M
M
Ishii
N
N
Kawakami
T
T
Nozawa
E
E
Hara
H
H
Miura
K
K
Ishii
N
N
D003558:Cystoscopy; D006801:Humans; D008297:Male; D008875:Middle Aged; D011677:Punctures; D013525:Surgical Instruments; D014521:Urethra / Q000293:injuries*; D014947:Wounds and Injuries / Q000628:therapy