Open AccessDelayed Anastomotic Urethroplasty in Children and Adolescence with Pelvic Fracture Urethral Injury (PFUI): Experiences in Two Centers of Reconstructive Urethral Surgery in Indonesia
Author(s) -
Paksi Satyagraha,
Kuncoro Adi,
I Made Udiyana Indradiputra,
Ahmad Agil,
Besut Daryanto
Publication year - 2021
Publication title -
indonesian medical and life science journal
Language(s) - English
Resource type - Journals
ISSN - 2774-9924
DOI - 10.53536/melisa.v1i2.17
Subject(s) - medicine , urethroplasty , surgery , pelvic fracture , anastomosis , reconstructive surgery , etiology , general hospital , incidence (geometry) , urethra , general surgery , pelvis , psychiatry , physics , optics
Incidence of pediatric pelvic fracture urethral injury (PFUI) is rare. This study reviews the experience of anastomotic urethroplasty surgery in children and adolescence PFUI in the last 3 years in two center of reconstructive urethral surgery in Indonesia.Method: This study retrospectively reviewed PFUI cases in Hasan Sadikin Hospital and Saiful Anwar Hospital from 2013-2016. The data cases were analysed base on aetiology of the trauma, urethral gap, and previous operations. The operation time and intra operative additional procedure to achieve tension free anastomotic was also noted.Result: A total 31 children and adolescence patients with PFUI were recorded in two institutions. Twenty patients were in Hasan Sadikin Hospital while 11 patients were in Saiful Anwar Hospital. The trauma mechanisms for PFUI were 28 (90.3%) cases due to motorcycle accidents and 3 (9.7%) cases due to high falls accidents. All patients underwent delayed urethral reconstruction in median 6 months (3-72). The median operation time was 150±101 minutes for children and 160±50.5 minutes for adolescence. The average length of the urethral gap in children cases was 2.8±1.2 cm, meanwhile 4±1.9 cm for adolescence cases. In order to achieve the tension free of anastomotic urethroplasty, 5 (16.1%) of PFUI patients underwent crural separation, 16 (51.6%) patients underwent inferior pubectomy and 3 (9.7%) patients for supracrural re-routing. Posterior pubectomy with omental wrap via transpubic approach was performed in one patient. The success rate for children cases was 83.3% and 88% for adolescence cases. Thus, the overall success rate after anastomotic urethroplasty for pediatric PFUI was 83.9%.Conclusions: In short-term follow up, delayed repair urethral reconstructive surgery by transperineal and transpubic anastomotic urethroplasty in children and adolescence with PFUI achieved a significant good result and showed promising outcome.