Current concepts in the management of pelvic fracture urethral distraction defects

Manikandan, Ramanitharan; Dorairajan, Lalgudi Narayanan; Kumar, Santosh

doi:10.4103/0970-1591.85444

Cited by 9 publications

(5 citation statements)

References 47 publications

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“…The results of these endoscopic urethrotomy are durable in most cases treated, and most authors accept these cases as successful urethroplasty. [23][24][25] Therefore, the overall result of current study is 96.76% which is comparable to published data.…”

Section: Methodssupporting

confidence: 88%

Outcome of everted end-to-end urethroplasty in traumatic bulbar and membranous urethra.

Shah,

Dipesh Shrestha,

Sajid Iqbal

2019

j Muhammad Med Coll

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Introduction: Numerous options are available for the surgical management of urethral strictures. Everted End-to-end anastomosis is the utmost effective management for bulbar and membranous urethral strictures with a documented high success rate with low postoperative morbidity. Methodology: This study was conducted at department of Urology, Lahore General hospital, Lahore from May 2012 till May 2014. Total 30 patients were included in the study. Procedure was done by a single surgical team and Uroflowmetry and subjective evaluation was done on 2nd week, 1st month and 4th month and 12th month post operatively. Results: Mean age of patients was 24.43±12.39 years. Mean stricture length preoperatively was 1.83±0.63 cm. On follow up 50% of patients were in each grade whose subjective grading were 1 and 2 at 2 week post operatively. After 1-month post operatively 76.67% patients had Grade-1 and 6.67% patients had Grade-2. After 1 month follow up 63.34% patients presented with grade-1, 20% with Grade-2 and 6.67% presented with Grade-3. Only 80% of the patients at 4th month and 1-year post operatively presented with grade-1 subjective improvement. 10% of the patients had stricture recurrence at 1-month follow up and another 10% had recurrence at 4 months of follow up. Conclusion: Everted End-to-end urethroplasty is treatment of choice for short traumatic bulbar and membranous urethral strictures with a high success rate. Key Words: Urethral Strictures, Everted End-to-end Urethroplasty, Bulbar Urethra, Membranous Urethra

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Section: Methodssupporting

confidence: 88%

Outcome of everted end-to-end urethroplasty in traumatic bulbar and membranous urethra.

Shah,

Dipesh Shrestha,

Sajid Iqbal

2019

j Muhammad Med Coll

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“…The clinical picture of urethral stricture, which significantly reduces the patient's quality of life, is manifested by symptoms of bladder outlet obstruction [2]. Damage to the urethra due to pelvic fracture can be associated with complications such as the formation of recurrent urethral stricture, urinary incontinence, and erectile dysfunction [7].…”

Section: Introductionmentioning

confidence: 99%

“…The incidence of urethral injury in men due to pelvic fracture varies widely. Two extensive literature reviews estimate the incidence of urethral trauma to be between 1.6% and 25% (mean 9.9%) [7]. In approximately 27% of cases, a fracture of the pelvic bones with damage to the urethra is combined with trauma to the abdominal organs [7].…”

Section: Introductionmentioning

confidence: 99%

Long-term Results of Optical Laser Urethrotomy for Post-traumatic Stricture of the Membranous Urethra

Nurberdiev,

Suchshenko,

Muralovich Kazhitaev

et al. 2024

WKMJ

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Urethral stricture is a common condition characterized by the narrowing of the urethra, leading to difficulty in urination. This article presents a case report of a 47-yearold male with urethral stricture following a pelvic fracture. The patient presented with urinary retention and a history of traumatic injury. Diagnostic imaging revealed a 2.0-2.2 cm stricture in the membranous urethra. Surgical intervention, including optical laser urethrotomy and silicone urethral catheter placement, was performed successfully. Postoperative management included antibacterial and anti-inflammatory therapy, leading to the restoration of independent urination. Urodynamic examination confirmed the successful outcome of the surgery. This case demonstrates that endoscopic surgery for urethral strictures can have a favorable prognosis. However, due to the potential for recurrence, ongoing outpatient care and monitoring by a urologist are essential for these patients.

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“…[ 7 8 ] Otherwise, it can lead to devastating complication such as urinary incontinence, urethracutaneous fistula, and restenosis. [ 9 ]…”

Section: Introductionmentioning

confidence: 99%

Outcome of anastomotic posterior urethroplasty with various ancillary maneuvers for post-traumatic urethral injury. Does prior urethral manipulation affect the outcome of urethroplasty?

2018

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Purpose:We present our success rate and complications of delayed anastomotic urethroplasty (DAU) in patients with post-traumatic posterior urethral injury.Materials and Methods:This was a retrospective study of patients aged ≥17 years that underwent DAU for post-traumatic posterior urethral injury during 2010–2014. Stricture length was measured by ascending and descending urethrogram. Success of procedure was considered when the patient was free of stricture-ralated obstruction and needed no further intervention. Primary group includes patients who underwent first time delayed urethroplasty while secondary group included patients who had some sort of urethral manipulation in local hospital. Results were analyzed using unpaired t-test, Chi-square test, binary logistic regression, Kaplan–Meier curves, and log-rank test.Results:Of the 80 male patients, 73 (91.25%) patients underwent primary DAU while 7 (8.75%) patients had secondary DAU. Median age, stricture length, and follow-up were 27.0 ± 12.7, 1.6 ± 0.9, and 3.2 ± 0.9, respectively. Overall, success rate was 83.75% while success rate in primary group was 89.04% and secondary group was only 28.57% (P = 0.0059). Regarding ancillary maneuvers, urethral mobilization alone was done in 29 (36.25%) patients with success rate (72.41%), corporeal body separation in 36 (45%) patients with success rate (91.66%), inferior wedge pubectomy in 13 (16.25%) with success rate (84.61%), supracrural rerouting in 1 (1.25%) with success rate (100%), and abdominoperineal approach in 1 (1.25%) with success rate of 100% (P = 0.193). Patients who had prior urethral manipulation affect the outcome of definitive anastomotic urethroplasty.Conclusion:DAU has durable success rate with less morbidity. Ancillary elaborated maneuvers are frequently needed in patients with complex and elongated post-traumatic posterior urethral defect with successful outcome.

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Current concepts in the management of pelvic fracture urethral distraction defects

Cited by 9 publications

References 47 publications

Outcome of everted end-to-end urethroplasty in traumatic bulbar and membranous urethra.

Outcome of everted end-to-end urethroplasty in traumatic bulbar and membranous urethra.

Long-term Results of Optical Laser Urethrotomy for Post-traumatic Stricture of the Membranous Urethra

Outcome of anastomotic posterior urethroplasty with various ancillary maneuvers for post-traumatic urethral injury. Does prior urethral manipulation affect the outcome of urethroplasty?

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