title: Long-term results of early endoscopic realignment of complete posterior urethral disruption.
abstract: OBJECTIVE
  To assess the long-term outcome of early endoscopic realignment (EER) of complete posterior urethral disruption.
  
  
  METHODS
  The study included 11 consecutive patients with complete posterior urethral disruption secondary to a road accident (n = 9) or a falling impact (n = 2). EER was performed using a simultaneous endoscopic transvesical and transurethral approach under fluoroscopic guidance. An 18F Foley urethral catheter was left for 4 weeks. All patients were evaluated postoperatively for incontinence, erectile dysfunction, and urethral strictures.
  
  
  RESULTS
  The patients' mean age was 32 years (range 20-62 y). The mean duration of the realignment procedure was 40 minutes (range 30-60 min), and it was performed within an average of 48 hours (range 3-72 h) from hospitalization. Efficient erection was maintained in five (45%) patients, and incontinence did not develop in any patient. Five (45%) patients in whom urethral strictures developed were treated initially by endoscopic urethrotomy (EU), which was successful in one patient. Three of the four in the EU failure group remained on periodic urethral dilation, refusing to undergo urethroplasty, and one patient with interposition of a pubic bone fragment underwent successful urethroplasty. There were no other complications during a mean follow-up of 4.3 years (range 2-7 y).
  
  
  CONCLUSIONS
  EER is a valuable alternative to long-term suprapubic drainage and delayed urethroplasty. Realignment failure did not interfere with the results of open urethroplasty. A further search for prognostic factors should improve the selection of patients for the early or the delayed approach.
authors.affiliation: Endourology Service, Tel Aviv Sourasky Medical Center, and Tel Aviv University, Sackler School of Medicine, Tel Aviv, Israel. mariosofer@hotmail.com
authors.forename: Mario
authors.initials: M
authors.lastname: Sofer
authors.forename: Nicola J
authors.initials: NJ
authors.lastname: Mabjeesh
authors.forename: Jacob
authors.initials: J
authors.lastname: Ben-Chaim
authors.forename: Galit
authors.initials: G
authors.lastname: Aviram
authors.forename: Yuval
authors.initials: Y
authors.lastname: Bar-Yosef
authors.forename: Haim
authors.initials: H
authors.lastname: Matzkin
authors.forename: Issac
authors.initials: I
authors.lastname: Kaver
mesh_terms: D000328:Adult; D004724:Endoscopy; D006801:Humans; D008875:Middle Aged; D011859:Radiography; D013997:Time Factors; D016896:Treatment Outcome; D014521:Urethra / Q000000981:diagnostic imaging / Q000293:injuries* / Q000601:surgery*; D055815:Young Adult