Document Detail


Delayed repair of post-traumatic posterior urethral distraction injuries: long-term results.
MedLine Citation:
PMID:  10840087     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVES: There is still controversy regarding the treatment of post-traumatic posterior urethral distraction injuries. Initial suprapubic cystostomy and delayed perineal urethral reconstruction has been considered the reference standard. In this report, we review our experience with delayed perineal urethral reconstruction, with a focus on the long-term outcome and complications. METHODS: A total of 77 men with posterior urethral distraction injury due to pelvic trauma underwent reconstruction with delayed perineal approach. In all cases, the area of fibrosis was aggressively excised, the corpus spongiosum was mobilized, and a tension-free, spatulated end-to-end anastomosis was achieved by splitting the corporeal bodies in 66.2% and by an additional perineally performed inferior pubectomy in 49.3% of the patients. The median time from injury to surgical repair was 12 months. The preoperative evaluation consisted of combined antegrade and retrograde cystourethrograms and cystourethrography. A detailed sexual history was obtained in 58 patients (75.3%). RESULTS: After a mean follow-up of 47 months (range 15 months to 14 years), the urethral continuity was adequate in 94. 8%; however, 2 patients required a perineal surgical revision (total of 79 operations). Postoperative incontinence was observed in 7 (9. 1%) of 77 patients. Postoperative erectile dysfunction was noted in 16.2% of patients who were known to be potent by history before surgery. CONCLUSIONS: Our results support the belief that delayed perineal reconstruction with extensive excision of fibrosis and a tension-free, spatulated end-to-end anastomosis is a successful treatment alternative for posterior urethral distraction defects, with acceptable morbidity.
Authors:
H M Tunc; A H Tefekli; T Kaplancan; T Esen
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Urology     Volume:  55     ISSN:  0090-4295     ISO Abbreviation:  Urology     Publication Date:  2000 Jun 
Date Detail:
Created Date:  2000-07-25     Completed Date:  2000-07-25     Revised Date:  2005-11-17    
Medline Journal Info:
Nlm Unique ID:  0366151     Medline TA:  Urology     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  837-41     Citation Subset:  IM    
Affiliation:
Department of Urology, Medical Faculty of Istanbul, University of Istanbul, Istanbul, Turkey.
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Child
Fractures, Bone / complications*
Humans
Male
Middle Aged
Pelvic Bones / injuries*
Time Factors
Treatment Outcome
Urethra / injuries*,  surgery*

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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