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.
First Department of Urology, Toho University School of Medicine, Tokyo, Japan. grandam@mba.sphere.ne.jp
K
K
Nakajima
M
M
Deguchi
N
N
Ishii
T
T
Kawakami
E
E
Nozawa
H
H
Hara
K
K
Miura
N
N
Ishii
D003558:Cystoscopy; D006801:Humans; D008297:Male; D008875:Middle Aged; D011677:Punctures; D013525:Surgical Instruments; D014521:Urethra / Q000293:injuries*; D014947:Wounds and Injuries / Q000628:therapy