Reconstruction of urethral injuries
Abstract
OBJECTIVES: To highlight the complexity of urethral injuries and to emphasise their prevention.
DESIGN: A retrospective study.
SETTING: Coast Province General Hospital, Mombasa, Kenya.
SUBJECTS: Twenty two male patients operated between 1997 and 2007.
RESULTS: Surgery for urethral injuries was done on 22 patients; 16 were of the posterior urethra, five bulbar urethra and one proximal penile urethra. The posterior urethral injuries were due to: pelvic fracture in 14, penetrating stick in one, and one animal injury by a buffalo. The bulbar urethral injuries were due to straddle injuries in four and one gunshot injury. The penile urethral injury was by compression of the subject by a motor vehicle against a wall. Anastomotic urethroplasty was performed in 20 patients, of whom 16 had complete recovery. Surgery for all bulbar and the penile urethral injuries was successful. Failure of repair with restenosis occurred in four patients with posterior urethral injuries. Bouginage was done in one patient who subsequently required no further treatment. Eventual total obliteration occurred in three patients. Reoperation was done in two of these with complete recovery in one and failure in the other who had two further urethroplasties, optical urethrotomy and is currently on clean intermittent self catheterisation. The fourth patient awaits reoperation. Sutureless membranous urethroplasty was done in two patients with posterior urethral injuries in whom sutures could not be inserted into…
How strong is the evidence?
Evidence Hub reads this as a cohort study, done in people. Its evidence level is 3 of 5 (Moderate · trial / cohort / secondary analysis). Trials without a large randomized design, cohorts and secondary analyses give moderate evidence. Reported size: 22 participants or records.
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