Early Endoscopic Realignment of Complete Traumatic Rupture of the Posterior Urethra

Guilhot, François; Cipolla, B.; Lévèque, Jean; Guirassy, S; Olivo, Jeremy; Lobel, Bernard

doi:10.1111/j.1464-410x.1991.tb15290.x

Cited by 42 publications

(21 citation statements)

References 5 publications

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“…The rate of stricture formation can reach 65%, similar to primary repairs, but the strictures usually respond well to a short course of urethral dilatations. Primary realignment can also be performed endoscopically [10].…”

Section: Discussionmentioning

confidence: 99%

Late urodynamic findings after treating traumatic rupture of the posterior urethra in boys

et al. 2006

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crush injury in two boys. Seven boys had an isolated urethral rupture, two also had a bladder neck injury and two also had a perforated bladder. No gross neurological impairment developed after trauma. Voiding cysto-urethrograms after initial therapy showed vesico-ureteric reflux in five boys, but in only one at the time of the urodynamic studies. At the time of urodynamic study, the mean ( SD ) age of the patients was 15 (6) years; seven were fully continent, one had intermittent leakage, two were incontinent, and one had nocturnal enuresis. CMG-electromyography (EMG) showed a reduced maximum cystometric capacity in nine patients, reduced compliance in 10, stable detrusor in 11, synergic detrusorsphincter activity in 11, and residual urine in one. The uroflowmetry-EMG study showed prolonged voiding time and flow time, decreased maximum flow urinary rate (Q max ) and mean flow rate (Q avg ). The shape of the flow curve showed an uninterrupted low-amplitude pattern.Comparing these patients with age-matched controls, CMG and uroflowmetry studies showed that the maximum cystometric bladder capacity, compliance, Q max and Q avg were all significantly lower in patients with PUD, while voiding time and flow time were significantly higher. CONCLUSIONThe LUT deteriorates after treating PUD in boys. CMG and uroflowmetry findings are consistent with partial anatomical obstruction distal to the bladder. Our results are preliminary and full urodynamics, including pressure-flow studies, will be useful to support this conclusion. A urodynamic study should be integral in the management of PUD.

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Section: Discussionmentioning

confidence: 99%

Late urodynamic findings after treating traumatic rupture of the posterior urethra in boys

et al. 2006

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“…120,123 Rates of stricture after PFUI will vary based on injury severity and management with PR or SPT, but in either scenario, stricture in most cases develops within a year of injury and can be treated by urethroplasty or direct vision internal urethrotomy. 22,125 Thus surveillance strategies with uroflowmetry, retrograde urethrogram, cystoscopy, or some combination of methods are recommended for the first year after injury. Impotence and incontinence are generally considered to be caused by the pelvic fracture itself rather than contemporary interventions for PFUI.…”

Section: Guideline Statementsmentioning

confidence: 99%

Urotrauma: AUA Guideline

et al. 2014

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Purpose The authors of this guideline reviewed the urologic trauma literature to guide clinicians in the appropriate methods of evaluation and management of genitourinary injuries. Methods A systematic review of the literature using the MEDLINE® and EMBASE databases (search dates 1/1/90-9/19/12) was conducted to identify peer-reviewed publications relevant to urotrauma. The review yielded an evidence base of 372 studies after application of inclusion/exclusion criteria. These publications were used to inform the statements presented in the guideline as Standards, Recommendations or Options. When sufficient evidence existed, the body of evidence for a particular treatment was assigned a strength rating of A (high), B (moderate) or C (low). In the absence of sufficient evidence, additional information is provided as Clinical Principles and Expert Opinions.

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“…In severe injury, trauma to the lower urinary tract occurs in 5-25% of cases [15,17,21]. Available clinico-pathologic studies try to establish a correlation between PRT and the occurrence of PUT [1,21].…”

Section: Conditions Producing the Mechanical Lesionsmentioning

confidence: 99%

Posterior urethral injuries associated with pelvic injuries in young adults: computerized finite element model creation and application to improve knowledge and prevention of these lesions

Bréaud¹,

Baqué²,

Loeffler³

et al. 2011

Surg Radiol Anat

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The model's application permitted us to analyze precisely the link between lateral impact trauma of the pelvic ring and lesions of the posterior urethra and to identify an urethra stretching prior to visualization of a pelvic fracture. Utilization of the model with other mechanisms of injury should allow for better comprehension of this associated trauma, improved prevention, iatrogenic aggravation of, and care for, these serious injuries.

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Early Endoscopic Realignment of Complete Traumatic Rupture of the Posterior Urethra

Cited by 42 publications

References 5 publications

Late urodynamic findings after treating traumatic rupture of the posterior urethra in boys

Late urodynamic findings after treating traumatic rupture of the posterior urethra in boys

Urotrauma: AUA Guideline

Posterior urethral injuries associated with pelvic injuries in young adults: computerized finite element model creation and application to improve knowledge and prevention of these lesions

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