The Type of Urethroplasty for a Pelvic Fracture Urethral Distraction Defect Cannot be Predicted Preoperatively

Andrich, Daniela E.; O’Malley, Kiaran; Summerton, Duncan J.; Greenwell, Tamsin; Mundy, Anthony R.

doi:10.1097/01.ju.0000076752.32199.40

Cited by 50 publications

(38 citation statements)

References 6 publications

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“…Whether or not the length of the fibrotic segment was significantly less and, more importantly, whether this actually is a significant factor in determining the outcome after DU has never been assessed. In our experience, the radiological length between the two ends at DU is generally short (92% are < 4 cm and most are < 2 cm), so short that it does not, of itself, affect the outcome at all except potentially adversely as discussed above [59].…”

Section: Fig 8 Augmented Bbasuturing the Two Ends Of The Urethra Amentioning

confidence: 96%

Urethral trauma. Part II: Types of injury and their management

Mundy¹,

Andrich²

2011

BJU International

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Section: Fig 8 Augmented Bbasuturing the Two Ends Of The Urethra Amentioning

confidence: 96%

Urethral trauma. Part II: Types of injury and their management

Mundy¹,

Andrich²

2011

BJU International

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“…a) . The length of the urethral stenosis, however, is often difficult to estimate accurately because of the possibility of poor filling of the posterior urethra with contrast material, and urethrography might not accurately determine the degree of three‐dimensional displacement of the posterior urethra . In addition, accompanying conditions, such as false passages, fistulas and periurethral diverticula, might not be well detected by the conventional urethrography .…”

Section: Delayed Management For Pfuimentioning

confidence: 99%

“…Andrich et al . found no significant association between the stenosis length and the type of urethroplasty, and concluded that it is impossible to predict it by preoperative urethrography . In order to overcome this problem, we previously evaluated the role of MRI in predicting the type of urethroplasty .…”

Section: Delayed Management For Pfuimentioning

confidence: 99%

Management of male pelvic fracture urethral injuries: Review and current topics

Horiguchi

2019

Int J of Urology

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Pelvic fractures from high‐energy blunt force trauma can cause injury to the posterior urethra, known as pelvic fracture urethral injury, which is most commonly associated with unstable pelvic fractures. Pelvic fracture urethral injury should be suspected if a patient with pelvic trauma has blood at the meatus and/or difficulty voiding, and retrograde urethrography should be carried out if the patient is stable. Once urethral injury is confirmed, urinary drainage should be established promptly by placement of a suprapubic tube or primary realignment of the urethra over a urethral catheter. Although pelvic fracture urethral injury is accompanied by subsequent urethral stenosis in a high rate and it has been believed that primary realignment can reduce the risk of developing urethra stenosis, it also has a risk of complicating stenosis and its clinical significance remains controversial. Once inflammation and fibrosis have stabilized (generally at least 3 months after the trauma), the optimal management for the resulting urethral stenosis is delayed urethroplasty. Delayed urethroplasty can be carried out via a perineal approach using four ancillary techniques in steps (bulbar urethral mobilization, corporal separation, inferior pubectomy and urethral rerouting). Although pelvic trauma can impair continence mechanisms, the continence after repair of pelvic fracture urethral injury is reportedly adequate. Because erectile dysfunction is frequently encountered after pelvic fracture urethral injury and most patients are young with a significant life expectancy, its appropriate management can greatly improve quality of life. In the present article, the key factors in the management of pelvic fracture urethral injury are reviewed and current topics are summarized.

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“…So, overall, experienced surgeons rely on their ability and competence in dealing with the intervention, rather than on the preoperative classification of the lesion [9]. However, an attempt to simplify the classification of delayed lesions in non-complex (e.g.…”

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confidence: 99%