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Long‐term Results of Treatment of Urethral Injuries in Males Caused by External Trauma
Author(s) -
JENKINS B. J.,
BADENOCH D. F.,
FOWLER C. G.,
BLANDY J. P.
Publication year - 1992
Publication title -
british journal of urology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.773
H-Index - 148
eISSN - 1464-410X
pISSN - 0007-1331
DOI - 10.1111/j.1464-410x.1992.tb15667.x
Subject(s) - medicine , urethroplasty , surgery , urethrotomy , suprapubic cystostomy , urethra , pelvic fracture , cystostomy , anastomosis , urethral stricture , pelvis
Summary— Of 134 males with traumatic rupture of the urethra seen between 1967 and 1989, 10 have been lost to follow‐up and 124 have been followed up for 1 to 22 years (mean 8); 100 patients had a pelvic fracture (3 with associated rectal injury) and 24 had perineal injuries. Prior to referral 31 patients (25%) had undergone treatment in addition to suprapubic cystostomy. Wherever possible, strictures were managed by optical urethrotomy (33) or intermittent dilatation (4). In 2 patients only a suprapubic cystostomy was possible. Skin inlay urethroplasty in 1 or 2 stages was performed in 75 cases, an end‐to‐end anastomosis with or without resection of the symphysis pubis in 7 and a scrotal tube pull‐through in 3. The immediate and long‐term results depended on the severity of the original injury. With minimal displacement the management was simple and the long‐term prognosis good, a single urethrotomy being sufficient in 22 patients. Where there was considerable displacement the initial management was more difficult and there was a high incidence of long‐term complications: of 73 patients treated by urethroplasty or end‐to‐end anastomosis, significant post‐operative infection occurred in 11 (15%) and restenosis in 15 (20%), of whom 7 required a revision urethroplasty. Data in respect of potency were recorded in 80 patients: 28 of these were impotent, 20 of the 28 having sustained an injury with considerable displacement.