EAU Guidelines on Urethral Trauma

Urethral Arterial Bleeding from an Iatrogenic Pseudoaneurysm due to Catheterization

“…Unlike sharp injuries, blunt trauma does not usually cause arterial bleeding and conservative treatment can be recommended. In fact, the European Association of Urology (EAU) guideline recommends inserting a catheter as the initial treatment for iatrogenic urethral injury [1]. Considering the local anatomy, arterial bleeding due to iatrogenic urethral injury seems to be a very unlikely event.…”

A Rare Case of Interstim Leads Site Pain

“…Complications of sacral neuromodulation have included pain at the site of the neurostimulatior in 15.3%, lead migration in 8.4%, infection in 6.1%, transient sensation of electrical shock in 5.5%, and pain at the lead site in 5.4%, with an overall surgical revision rate of 33% [1]. Thus, this patient's complication is not rare, however, further detail on the specific causes of lead site pain in previous studies have not been described.…”

“…Published data has shown significant success with sacral nerve stimulation, but has also cited complications including pain at the lead site, lead migration, and infection leading to revision rates of approximately 30% [1]. We report a case of pain at the lead site secondary to the protrusion of lead tines in a patient with a slim body habitus.…”

Risk Factors Associated with Lower Urinary Tract Injuries in Traumatic Pelvic Fractures

“…Partial tears may be managed with urethral catheterisation; however insertion of suprapubic catheter is recommended for both partial and complete urethral ruptures, using transabdominal sonography if the bladder is not easily palpable [6]. Complete urethral rupture can be managed acutely, within the first ten days, with primary endoscopic realignment or immediate open urethroplasty [6].…”

“…Partial tears may be managed with urethral catheterisation; however insertion of suprapubic catheter is recommended for both partial and complete urethral ruptures, using transabdominal sonography if the bladder is not easily palpable [6]. Complete urethral rupture can be managed acutely, within the first ten days, with primary endoscopic realignment or immediate open urethroplasty [6]. Delayed treatment options include delayed primary urethroplasty, one to two weeks after injury, delayed formal urethroplasty, at or later than three months following injury, or delayed endoscopic incision, which carries a high failure rate [6].…”