Updated Outcomes of Early Endoscopic Realignment for Pelvic Fracture Urethral Injuries at a Level 1 Trauma Center

Urology
Paul H ChungBryan Voelzke

Abstract

To present our updated experience and discuss potential benefits of early endoscopic realignment (EER) for patients with pelvic fracture urethral injuries (PFUIs). A retrospective review of patients treated with EER after blunt PFUIs was performed. EER was performed with a retrograde or a combined antegrade or retrograde approach with a cystoscope. Treatment success was defined as no secondary procedure or the ability to pass a cystoscope across the area of injury or surgical anastomosis. Thirty-two patients (mean age 38 years, range 17-73) underwent EER between 2004 and 2016 with a mean follow-up of 26 months (range 1-102). Median time to realignment was 2 days (range 0-6) and was performed concomitantly with another surgical service in 72% of cases. Median operative time for EER was 38 minutes (range 8-100). Using an intent-to-treat analysis, 29 patients (91%) failed EER. Nine patients underwent a subsequent endoscopic procedure with 22% success rate. Excision and primary anastomotic urethroplasty was performed in 24 patients as a primary or secondary treatment with 96% success rate. Our overall success rate for EER was 9%, but did not hinder subsequent urethroplasty success. The decision for performing EER should not be base...Continue Reading

Citations

Mar 22, 2019·International Journal of Urology : Official Journal of the Japanese Urological Association·Akio Horiguchi
May 31, 2019·World Journal of Urology·Niels Vass JohnsenUNKNOWN Trauma Urologic Reconstruction Network of Surgeons(TURNS)
Oct 13, 2020·Journal of Endourology·Zejian ZhangXisheng Wang

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