Magnetic Resonance Imaging and Pelvic Fracture Urethral Injuries

Gaspar, Sandro Roberto da Silva; Ferreira, Natália; Oliveira, Tiago; Oliveira, Pedro Simões de; Dias, Josiane Mourão; Lopes, Tomé

doi:10.1016/j.urology.2017.06.041

Cited by 12 publications

(14 citation statements)

References 47 publications

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“…There is a tendency to over-diagnose complete rupture on urethrography alone. Other imaging modalities have been investigated especially prior to elective delayed repair including CT and MRI ( 114 , 115 ). Contrast MRI urethrography is the most promising as it shows 3D urethral anatomy and allows for advanced preoperative planning ( 116 ).…”

Section: Initial Assessmentmentioning

confidence: 99%

Pelvic fracture urethral injury in males—mechanisms of injury, management options and outcomes

Barratt

Bernard

Mundy

et al. 2018

Transl. Androl. Urol.

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Pelvic fracture urethral injury (PFUI) management in male adults and children is controversial. The jury is still out on the best way to manage these injuries in the short and long-term to minimise complications and optimise outcomes. There is also little in the urological literature about pelvic fractures themselves, their causes, grading systems, associated injuries and the mechanism of PFUI. A review of pelvic fracture and male PFUI literature since 1757 was performed to determine pelvic fracture classification, associated injuries and, PFUI classification and management. The outcomes of; suprapubic catheter (SPC) insertion alone, primary open surgical repair (POSR), delayed primary open surgical repair (DPOSR), primary open realignment (POR), primary endoscopic realignment (PER), delayed endoscopic treatment (DET) and delayed urethroplasty (DU) in male adults and children in all major series have been reviewed and collated for rates of restricture (RS), erectile dysfunction (ED) and urinary incontinence (UI). For SPC, POSR, DPOSR, POR, PER, DET and DU; (I) mean RS rate was 97.9%, 53.9%, 18%, 58.3%, 62.0%, 80.2%, 14.4%; (II) mean ED rate was 25.6%, 22.5%, 71%, 37.2%, 23.6%, 31.9%, 12.7%; (III) mean UI rate was 6.7%, 13.6%, 0%, 14.5%, 4.1%, 4.1%, 6.8%; (IV) mean FU in months was 46.3, 29.4, 12, 61, 31.4, 31.8, 54.9. For males with PFUI restricture and new onset ED is lowest following DU whilst UI is lowest following DPOSR. On balance DU offers the best overall outcomes and should be the treatment of choice for PFUI.

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Section: Initial Assessmentmentioning

confidence: 99%

Pelvic fracture urethral injury in males—mechanisms of injury, management options and outcomes

Barratt

Bernard

Mundy

et al. 2018

Transl. Androl. Urol.

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show abstract

“…61,[67][68][69] Among patients with neural abnormalities, impaired function was found in bulbocavernosus reflex (76%), pudendal nerve (30%) and posterior tibial somatosensory nerve (37%). 70 Overall, the most important causes seem to be the disruptions of the cavernous nerves, 66,69,71,72 lateral to the prostatomembranous urethra. 66,71 Diagnosis of ED and its cause may be achieved with nocturnal penile tumescence testing, penile duplex ultrasound and neurophysiological testing.…”

Section: Resultsmentioning

confidence: 99%

“…70 Overall, the most important causes seem to be the disruptions of the cavernous nerves, 66,69,71,72 lateral to the prostatomembranous urethra. 66,71 Diagnosis of ED and its cause may be achieved with nocturnal penile tumescence testing, penile duplex ultrasound and neurophysiological testing. 70 In addition, penile duplex ultrasound with intracavernous injection may be performed.…”

Section: Resultsmentioning

confidence: 99%

Rehabilitative management of pelvic fractures: a literature-based update

et al. 2021

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A comprehensive rehabilitation program is required after Pelvic Fracture (PF). In a PF rehabilitation setting an effective treatment and a proper management of complications is supplied by an appropriate and reliable clinical assessment. In this literature-based update, we search on MEDLINE, EMBASE, and the Cochrane Database of Systematic reviews to find articles, scientific society guidelines and practioners experiences defining the rehabilitative management of clinically PF outcomes. Based on literature evidences and expert opinions, a set of key topics was collated to generate advices and recommendations to put into daily practice. Even if there are no high-quality evidence for rehabilitative interventions after PF in terms of duration and modality of therapy, rehabilitation setting, care pathways, and long-term functional outcomes, it is strongly recommended an early multidisciplinary intervention to improve recovery from PF.

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“…Because of the given proximity between the prostate and the genitals, penile anatomy and vasculature are often depicted on these imaging studies. Hence, magnetic resonance imaging had been widely used to evaluate post-traumatic impotence, penile prosthesis, penile fracture, or fibrous plaques in Peyronie's disease (64)(65)(66).…”

Section: Magnetic Resonance Arteriography (Mra)mentioning

confidence: 99%

Current approaches to the diagnosis of vascular erectile dysfunction

Ma¹,

Bian²,

Qin³

et al. 2020

Transl Androl Urol

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Vascular erectile dysfunction (ED) is closely related to cardiovascular events, and early diagnosis of vascular ED may be helpful to predict the occurrence of cardiovascular events and improve prognosis.At present, there are many approaches to diagnose ED, but each method has its advantages and limitations.This study retrospectively reviewed all available literature focusing on the diagnosis of vascular ED through a systematic PubMed and EMBASE search. According to the different application scenarios, the main methods for the diagnosis of vascular ED are divided into four categories. Intra-cavernous injection of vasoactive drugs is the earliest method used in the diagnosis of vascular ED and is a basic test. For the diagnosis of arterial ED, color duplex Doppler ultrasound, selective penile angiography, magnetic resonance imaging, and computed tomography are more commonly used. While for the diagnosis of venous ED, shear wave elastography, dynamic infusion cavernosometry and cavernosography are more accurate. Endo-peripheral arterial tonometry (PAT) has also been used to detect vascular endothelial function. Although various existing examinations are widely used for the evaluation of vascular ED, they still have some shortcomings, such as invasiveness, contingency, high false positive (negative) rate. New methods of long-term dynamic detection are needed.

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Magnetic Resonance Imaging and Pelvic Fracture Urethral Injuries

Cited by 12 publications

References 47 publications

Pelvic fracture urethral injury in males—mechanisms of injury, management options and outcomes

Pelvic fracture urethral injury in males—mechanisms of injury, management options and outcomes

Rehabilitative management of pelvic fractures: a literature-based update

Current approaches to the diagnosis of vascular erectile dysfunction

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