Long-term outcome of posterior urethral rupture in boys: a comparison of different surgical modalities.
OBJECTIVE
To evaluate the long-term outcome of posterior urethral rupture due to pelvic trauma.


METHODS
We retrospectively reviewed the records of 49 children with posterior urethral rupture from 1986 to 2000. The urologic evaluation at the last follow-up visit was made by the same surgeon and included physical examination, ultrasonography, simultaneous retrograde urethrography, and voiding cystourethrography, as well as cystourethroscopy in some cases. The long-term urologic results were determined by voiding function, continence and erectile function, and semen analysis.


RESULTS
The mean follow-up was 12 years (range 4 to 17). The average age was 8 years at the time of trauma and 20 years at the last follow-up visit. Primary realignment (22 patients), immediate repair (8), and delayed repair (16) were performed for posterior urethral rupture. Urethral continuity was achieved in 97.9% of patients, and 30 (61.2%) were free of symptoms. The overall rate of long-term complications was significantly greater in patients with a prostatic urethra location injury, and it was similar for the three surgical procedures.


CONCLUSIONS
The results of our study have shown that, apart from partial injury, all types of surgical treatment are equally problematic, with similar complication rates and long-term morbidity. The procedure of choice should be individualized, depending on the anatomy and the extent of the urethral injury, stability of the patient, and presence of additional injuries.
Onen
Abdurrahman
A
Department of Pediatric Surgery, Dicle University School of Medicine, Diyarbakir, Turkey. aonenmd@hotmail.com
Oztürk
Hayrettin
H
Kaya
Mete
M
Otçu
Selçuk
S
D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D007172:Erectile Dysfunction / Q000209:etiology; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D011183:Postoperative Complications; D012086:Reoperation; D012421:Rupture; D014521:Urethra / Q000293:injuries* / Q000601:surgery*; D014525:Urethral Stricture / Q000209:etiology; D014549:Urinary Incontinence / Q000209:etiology; D013521:Urologic Surgical Procedures, Male / Q000379:methods; D014949:Wounds, Nonpenetrating / Q000150:complications