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Endoscopic management of a traumatic disruption of the bulbous urethra using a thin trocar puncture
Author(s) -
Nakajima Koichi,
Deguchi Masao,
Ishii Norie,
Kawakami Toshifumi,
Nozawa Eiyu,
Hara Hiroshi,
Miura Kazukiyo,
Ishii Nobuhisa
Publication year - 2001
Publication title -
international journal of urology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.172
H-Index - 67
eISSN - 1442-2042
pISSN - 0919-8172
DOI - 10.1046/j.1442-2042.2001.00284.x
Subject(s) - cystoscope , medicine , urethra , foley catheter , surgery , urethrotomy , endoscopy , cystoscopy , lithotomy position , fluoroscopy , penetration (warfare) , catheter , urethroplasty , anatomy , urinary system , alternative medicine , pathology , operations research , engineering
A case is reported in which complete disruption of the bulbous urethra resulted in a straddled‐type injury, which was managed by endoscopic realignment with a thin trocar needle. The endoscopic urethroplasty consisted of: (i) direct observation of the proximal end of the obliterated urethra by an antegrade flexible cystoscope; (ii) adjustment of the direction of trocar penetration under fluoroscopy and direct vision; (iii) confirmation of the exact trocar position and penetration by antegrade flexible cystoscope; and (iv) placement of the guidewire following the trocar penetration as guidance for urethrotomy. A Foley catheter was left in place for 6 weeks. To date, no further endoscopic revision has been required. Although long‐term follow up and more experience are required, this technique is reported because it appears to be safe, reproducible, simple and minimally invasive.