Open AccessOutcomes Following Primary Realignment Versus Suprapubic Cystostomy with Delayed Urethroplasty for Pelvic Fracture-Associated Posterior Urethral Injury: A Systematic Review with Meta-Analysis
Author(s) -
Alexander Light,
Tanya Gupta,
Maria Dadabhoy,
Allen Daniel,
Madura Nandakumar,
Abigail Burrows,
Sandeep Karthikeyan
Publication year - 2019
Publication title -
current urology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.476
H-Index - 13
eISSN - 1661-7657
pISSN - 1661-7649
DOI - 10.1159/000499282
Subject(s) - medicine , urethroplasty , urethral stricture , suprapubic cystostomy , meta analysis , urinary incontinence , surgery , pelvic fracture , odds ratio , randomized controlled trial , confidence interval , cystostomy , erectile dysfunction , urology , urethra , pelvis
Pelvic fracture can be complicated by posterior urethral injury (PUI) in up to 25% of cases. PUI can produce considerable morbidity, including urethral stricture, erectile dysfunction (ED), and urinary incontinence. Optimal management of PUI is unclear, however, the current gold standard is placement of a suprapubic cystostomy with delayed urethroplasty (SCDU) performed several months later. Another option is early primary realignment (PR) with urethral catheter, performed either open or endoscopically. Through a systematic review and meta-analysis, we aimed to compare PR and SCDU regarding stricture, ED, and urinary incontinence rates. In light of advancing endoscopic techniques, we also aimed to compare early endoscopic realignment (EER) alone with SCDU.