Comparison of long-term results according to the primary mode of management and type of injury for posterior urethral injuries.
BACKGROUND
We retrospectively reviewed the records of patients with traumatic posterior urethral injuries, analyzed postoperative findings to compare the results of the primary mode of management, and evaluated whether the Colapinto and McCallum classification system was valuable for predicting the complications.


METHODS
55 patients with traumatic posterior urethral injuries were included in the study. A total of 35 patients underwent immediate realignment over a Foley catheter including direct Foley catheter insertion (group 1) and 20 underwent initial suprapubic tube placement followed by delayed urethroplasty (group 2). Urethral injuries were interpreted using the Colapinto and McCallum classification based on the retrograde urethrographies.


RESULTS
44 (80.0%) of the patients were classified to type III in both groups (group 1, 29 [82.9%]; group 2, 15 [75.0%]). Of group 1, mild, moderate and severe urethral strictures developed in 7 (20.0%), 8 (22.9%) and 6 (17.1%), respectively, and developed in 6 (30.0%), 2 (10.0%) and 5 (25.0%), respectively, of group 2. Six (17.1%) and 2 (20.0%) had decreased potency and 4 (11.5%) and 1 (5.0%) were impotent in group 1 and 2, respectively. Of group 1, incontinence developed in 3 patients but 1 did not need treatment, and developed in 2 (10.0%) but 1 (5.0%) did not need treatment of group 2. The score test for trend demonstrated that there were no significant differences of these results.


CONCLUSIONS
Our findings suggest that complications in patients with posterior urethral injuries are not related to the primary mode of management. Because most injuries are type III, the evolution toward the classification system is needed.
Ku
Ja Hyeon
JH
Department of Urology, Military Manpower Administration, Taejeon, Korea. randyku@hanmail.net
Jeon
Youn Soo
YS
Kim
Min Eui
ME
Lee
Nam Kyu
NK
Park
Young Ho
YH
D000293:Adolescent; D000328:Adult; D005500:Follow-Up Studies; D006801:Humans; D015601:Injury Severity Score; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000175:diagnosis; D011336:Probability; D012189:Retrospective Studies; D018570:Risk Assessment; D018709:Statistics, Nonparametric; D013997:Time Factors; D016896:Treatment Outcome; D014521:Urethra / Q000293:injuries*; D014522:Urethral Diseases / Q000209:etiology / Q000601:surgery*; D014525:Urethral Stricture / Q000175:diagnosis / Q000453:epidemiology; D014546:Urinary Catheterization / Q000379:methods; D013521:Urologic Surgical Procedures, Male / Q000379:methods*; D014947:Wounds and Injuries / Q000175:diagnosis / Q000601:surgery*