[Post-traumatic rupture of the urethra: a series of 105 cases].
OBJECTIVE
To evaluate the management of patients with post-traumatic urethral stricture in our institution.


METHODS
From January 1988 to August 2005, 180 surgical procedures were performed in 105 patients for post-traumatic lesions of the bulbomembranous urethra after fracture of the pelvis (79%) or perineal trauma (21%). This series of 180 operations comprised 99 urethroplasties (54 anastomotic urethroplasties, 39 two-stage urethroplasties and 6 one-stage augmentation urethroplasties) and 80 endoscopic procedures (74 endoscopic urethrotomies, 2 endoscopic realignments, 5 stent placements). The median follow-up was 4.5 years. Success rates were calculated by the Kaplan-Meier actuarial method.


RESULTS
The 1-year and 5-year satisfactory result rates for urethroplasty were 84% and 81% after anastomotic urethroplasty and 78% and 53% after two-stage urethroplasty respectively. The best results were obtained when anastomotic urethroplasty was performed prior to any endourethral manipulation (95% of 5-year satisfactory results). Urethrotomies performed for recurrence after urethroplasty achieved 70% of 5-year satisfactory results.


CONCLUSIONS
The results of anastomotic urethroplasty for traumatic stricture of the bulbomembranous urethra are more satisfactory and more stable when this procedure is performed prior to any endourethral manipulation. Recurrences after urethroplasty for post-traumatic stricture can be treated by endoscopic urethrotomy with satisfactory long-term results.
Culty
Thibaut
T
Clinique Urologique, Hôpital Bichat, Paris, France. thibautculty@yahoo.com
Ravery
Vincent
V
Boccon-Gibod
Laurent
L
D000328:Adult; D006801:Humans; D008297:Male; D012421:Rupture; D013997:Time Factors; D014521:Urethra / Q000293:injuries* / Q000601:surgery*; D014525:Urethral Stricture / Q000209:etiology / Q000601:surgery*; D013521:Urologic Surgical Procedures, Male / Q000379:methods