Unusual cause of failure of end-to-end anastomotic urethroplasty for traumatic obliterative bulbar urethral stricture.
End-to-end anastomotic urethroplasty (EEA) for traumatic bulbar urethral stricture has excellent long-term success rate. We encountered a patient with obliterative bulbar stricture and persistent phlegmon in perineum resulting from straddle injury. Phlegmon-excision and EEA was performed, which ended up in recurrence. Thorough excision of recurrent nodules & scar with stage-I urethroplasty was performed using 'scrotal shutter flap'. Histopathology of phlegmon of first surgery and nodules & urethral margins of second revealed amyloidosis. Stage-II urethroplasty was performed 3-months later after which he is well at 24 months follow-up. This is the first case of perineal-urethral amyloid associated with trauma. Etiology is elusive.
Department of Urology, Advanced Urology Center, Nehru Hospital, PGIMER, Chandiagrh, India.
Mayank M
MM
Agarwal
Arup K
AK
Mandal
Debansu
D
Sarkar
Ravimohan
R
Mavuduru
Shrawan K
SK
Singh
D000368:Aged; D000714:Anastomosis, Surgical / Q000379:methods; D006801:Humans; D008297:Male; D017211:Treatment Failure; D014521:Urethra / Q000293:injuries* / Q000601:surgery*; D014525:Urethral Stricture / Q000209:etiology / Q000601:surgery*