Primary Realignment of Posterior Urethral Injuries

Patterson, David E.; Barrett, David M.; Myers, Robert P.; DeWeerd, James H.; Hall, Brad B.; Benson, Ralph C.

doi:10.1016/s0022-5347(17)52209-0

Cited by 66 publications

(13 citation statements)

References 6 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The following arguments are specified for the procedure: lower rate of impotence, lower rate of incon tinence, simpler later treatment of the stricture [11]. On the other hand, there are the advocates of primary treat ment with exposure, drainage, realignment and possibly suture and adaptation of the urethral stumps [12][13][14], The advantages of this procedure are control of hemor rhage, drainage of hematoma and extravasate, lower scar formation, above all in prostatourethral dislocation, pos sibility of avoiding posttraumatic strictures [13]. In our series of heterogenous urethral lesions, the two groups (conservative/primary surgical care) are only compara ble to a limited extent.…”

Section: Discussionmentioning

confidence: 99%

Pelvic Fractures and Traumatic Lesions of the Posterior Urethra

Zingg

Casanova²,

Isler³

et al. 1990

Eur Urol

View full text Add to dashboard Cite

Section: Discussionmentioning

confidence: 99%

Pelvic Fractures and Traumatic Lesions of the Posterior Urethra

Zingg

Casanova²,

Isler³

et al. 1990

Eur Urol

View full text Add to dashboard Cite

“…Ying-Hao et al [13] evaluated 16 men who had bulbar urethral disruption with endoscopic realignment and reported that all cases were successfully treated in a single session without intraoperative or postoperative complications. However, so far, there is controversy regarding postoperative stricture, complications such as impotence and incontinence, and pelvic abscess [16-18]. With attempted urethral "realignment" over a urethral catheter, the rate of stenosis increases from -10 to -65% in incomplete disruption and from -75 to -100% in complete disruption [16].…”

Section: Discussionmentioning

confidence: 99%

Comparison of Immediate Primary Repair and Delayed Urethroplasty in Men with Bulbous Urethral Disruption after Blunt Straddle Injury

Gong

Choi

et al. 2012

Korean J Urol

View full text Add to dashboard Cite

PurposeThe aim of this study was to analyze the outcomes of immediate primary repair (IPR) compared with delayed repair (DR) after initial suprapubic cystostomy.Materials and MethodsWe reviewed the records of 60 patients with bulbous urethral disruption after blunt trauma from February 2001 to March 2011. Seventeen patients who presented in an acute injury state underwent IPR; 43 patients underwent DR after the initial suprapubic cystostomy. None of the patients had undergone previous urethral manipulation. We compared the outcomes, including stricture, impotence, and incontinence, between the two management approaches. We also measured the time to spontaneous voiding, the duration of suprapubic diversion, and the number of days spent in the hospital.ResultsThe median follow-up was 20.5 months (range, 13 to 59 months; mean, 23.3 months). Among 17 patients in the IPR group, strictures developed in 2 patients (11.7%), and among 53 patients in the DR group, strictures developed in 8 patients (18.6%, p=0.709). The incidences of impotence and incontinence were similar in both groups (17.6% and 0% in the IPR group vs. 27.9% and 4.6% in the DR group, p=0.520 and 1.000, respectively). The time to spontaneous voiding and the duration of suprapubic diversion were significantly shorter in the IPR group (average 27.3 and 33.4 days, respectively) than in the DR group (average 191.6 and 198.1 days, respectively; p<0.001 and <0.001).ConclusionsIPR may provide comparable outcomes to DR and allow for shorter times to spontaneous voiding and reduce the duration of suprapubic diversion.

show abstract

“…In experienced hands, such an approach has been demonstrated to have better outcomes as compared to insertion of a suprapubic cystostomy alone. [21]…”

Section: Discussionmentioning

confidence: 99%

Primary urethral realignment should be the preferred option for the initial management of posterior urethral injuries

Shrinivas¹,

Dubey²

2010

Indian J Urol

View full text Add to dashboard Cite

The initial management of posterior urethral injuries is controversial. Options of management include immediate surgical realignment, early realignment using minimally invasive techniques or simple suprapubic catheter (SPC) placement followed by delayed urethroplasty. The latter method has been preferred by most urologists but the last couple of decades have seen increasing reports of early urethral realignment which have provided better if not similar results as SPC placement. In this article a detailed analysis of studies involving primary realignment has been presented to reinforce the argument in favor of this approach.

show abstract

Primary Realignment of Posterior Urethral Injuries

Cited by 66 publications

References 6 publications

Pelvic Fractures and Traumatic Lesions of the Posterior Urethra

Pelvic Fractures and Traumatic Lesions of the Posterior Urethra

Comparison of Immediate Primary Repair and Delayed Urethroplasty in Men with Bulbous Urethral Disruption after Blunt Straddle Injury

Primary urethral realignment should be the preferred option for the initial management of posterior urethral injuries

Contact Info

Product

Resources

About