Role of Magnetic Resonance Imaging in Assessment of Posterior Urethral Distraction Defects

Koraitim, Mamdouh M.; Reda, Ihab S.

doi:10.1016/j.urology.2007.04.039

Cited by 42 publications

(30 citation statements)

References 8 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Magnetic resonance imaging has been reported to aid in delineating the precise site and density of scar tissue in posterior urethral distraction defects [18]. The preoperative measurement of the amount of fibrotic tissue and the dead space size by imaging can be used preoperatively to indicate when a GMF should be used.…”

Section: Discussionmentioning

confidence: 99%

Clinical Factors That Predict Successful Posterior Urethral Anastomosis With a Gracilis Muscle Flap

et al. 2013

View full text Add to dashboard Cite

PurposeWe evaluated the preoperative clinical factors that affect the surgical outcome of posterior urethral anastomosis (PUA) with a gracilis muscle flap (GMF) to determine which factors predict benefit from the use of the GMF.Materials and MethodsThis was a retrospective analysis of 49 patients who underwent a delayed PUA with a GMF. A successful clinical outcome was defined as achieving a peak urinary flow rate greater than 15 mL/s at 3 and 12 months postoperatively without evidence of stricture recurrence on a retrograde urethrogram or cystourethroscopy at 3 months postoperatively. Multiple clinical factors were evaluated by use of univariate and multivariate analyses.ResultsThe outcome of 21 of 49 patients (42.9%) was deemed successful. The mean age of the 49 patients was 37.2±13.5 years and the mean follow-up duration was 43.4±28.0 months. The length of the urethral defect was significantly shorter in patients with a successful outcome than in patients with an unsuccessful outcome (p=0.010). The outcome differed significantly depending on whether the patients had a previously successful urethroplasty (p=0.036) or whether they had suffered a pelvic bone injury (p=0.012). Multivariate logistic regression analyses revealed that a previous urethroplasty was the only preoperative clinical factor that significantly affected the surgical outcome in PUA with a GMF (odds ratio, 0.218; 95% confidence interval, 0.050 to 0.947; p=0.042).ConclusionsA history of previous urethroplasty is a preoperative clinical factor that significantly affects the surgical outcome in PUA with a GMF; the procedure is more likely to be successful in patients who have not previously undergone urethroplasty.

show abstract

Section: Discussionmentioning

confidence: 99%

Clinical Factors That Predict Successful Posterior Urethral Anastomosis With a Gracilis Muscle Flap

et al. 2013

View full text Add to dashboard Cite

show abstract

“…On the other hand, MRI has some limitations in its use with patients with claustrophobia and patients with metal prosthesis or a pacemaker. MRI also has some further disadvantages that still limit its clinical application, including expensive cost, difficulty in obtaining digital subtraction details of the urethra and unfamiliarity to the urologist [2,10]. …”

Section: Discussionmentioning

confidence: 99%

Flexible Cystoscope for Evaluating Pelvic Fracture Urethral Distraction Defects

Li¹,

Long²,

Xu³

et al. 2012

Urol Int

View full text Add to dashboard Cite

Objective: To describe the value of flexible cystoscopy versus conventional urethrography (retrograde urethrography and cystourethrography) in diagnosing pelvic fracture urethral distraction defects (PFUDDs). Patients and Methods: Between May 2010 and June 2011, 120 male patients with PFUDDs were evaluated. In this study, all patients underwent conventional urethrography after admission. Flexible cystoscopy was also used for comparison, followed by conventional urethrography. The flexible cystoscope was introduced into the posterior urethra and the area was evaluated for the length of the proximal urethra and any possible fistulas, false passages, calculi or displacement of the posterior urethra. Results: Severe allergic reaction or obvious discomfort did not occur in any patients after conventional urethrography or flexible cystoscopy. By comparing the data obtained from flexible cystoscopy to those from conventional urethrography, no statistical difference was found in the measured length of the proximal posterior urethra (4.31 ± 2.28 vs. 4.02 ± 3.12, p > 0.05). However, the rate of detection in other abnormalities was higher in flexible cystoscopy than in conventional urethrography (48.3 vs. 10.8%, p < 0.05). Seventeen (14.2%), 9 (7.5%) and 32 (26.7%) patients were detected with fistula, false passage and calculus, respectively, according to flexible cystoscopy. In comparison, fistula, false passage and calculus were only observed in 2 (1.7%), 7 (5.8%) and 4 (3.3%) patients, respectively, through conventional urethrography imaging. Conclusions: Flexible cystoscopy is a valuable procedure in the evaluation of the posterior urethra and bladder neck, and in patients with urethral distraction defects before surgery. More details about fistulas, false passages, calculi and urethral defects could be obtained through this method.

show abstract

“…Tausch et al study included 19 patients with prostatic or posterior urethral injuries who recovered without stricture or voiding dysfunction. 14 Antiseptic conditions and antibiotic treatment have lowered the risk of complications, with highly sensitive imaging, 18,19 and open or endoscopic elective management in reserve.…”

Section: Discussionmentioning

confidence: 99%

The Pelvic Wound of Joshua Lawrence Chamberlain Revisited

Lightner

Evans

2009

Journal of Pelvic Medicine and Surgery

View full text Add to dashboard Cite

Objectives: Joshua Lawrence Chamberlain, a hero of the Union during the American Civil War, suffered a major urologic injury in battle. Because of his recent resurgence of fame, there has been interest in his survival from a devastating pelvic wound. The literature has described his treatment as involving a possibly unprecedented repair of the proximal urethra and/or bladder neck. We have reexamined the primary and secondary literature to define, as far as we can determine for the first time, exactly what was done at the time of his injury. Methods: We reviewed available primary and secondary sources, including Chamberlain's letters and writings, regarding the time of his wounding and subsequent care, comparing these documents with current urologic management of such injuries.Results: Chamberlain's treatment was determined by the then current principles of treatment of urethral and bladder injuries. An invasive reconstruction would have been inconsistent with the abilities and practice of the times. The life-saving procedure referred to by many sources was both crucial and simple: an ultimately successful catheterization of a badly damaged proximal urethra and/or bladder neck.Conclusions: The treatment of Chamberlain's wound was difficult but in principal straightforward. Given the technical limitations of the time, this treatment is fully consistent with both modern and urologic principles of 150 years ago.

show abstract

Role of Magnetic Resonance Imaging in Assessment of Posterior Urethral Distraction Defects

Cited by 42 publications

References 8 publications

Clinical Factors That Predict Successful Posterior Urethral Anastomosis With a Gracilis Muscle Flap

Clinical Factors That Predict Successful Posterior Urethral Anastomosis With a Gracilis Muscle Flap

Flexible Cystoscope for Evaluating Pelvic Fracture Urethral Distraction Defects

The Pelvic Wound of Joshua Lawrence Chamberlain Revisited

Contact Info

Product

Resources

About