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    Korean J Urol. 2007 Nov;48(11):1165-1170. Korean.
    Published online Nov 30, 2007.
    https://doi.org/10.4111/kju.2007.48.11.1165
    Copyright © 2007 The Korean Urological Association
    Original Article

    5 Year Follow-up Results of Endoscopic Primary Realignment in Urethral Injury

    Chang Soo Park, Sung Woo Park, Jung Man Kim,1 and Jeong Zoo Lee
      • Department of Urology, College of Medicine, Pusan National University, Busan, Korea.
      • 1Masan-si Health Center, Masan, Korea,
    • Corresponding author (Email: toohotman@hanmail.net )
    Received April 05, 2007; Accepted September 17, 2007.

    Abstract

    Purpose

    The standard management of posterior urethral injury is controversial with regard to immediate primary realignment versus delayed urethroplasty. We analyzed the long-term results of treatment for urethral injury with performing immediate primary realignment.

    Materials and Methods

    19 patients with urethral injury were treated by endoscopic primary realignment from March 2000 to March 2002. Anterior and posterior urethral injuries were classified into the A and P groups, respectively, and the A and P groups had 11 and 8 patients, respectively. We investigated 5-years of follow-up complications, which were composed of urethral stricture, incontinence and impotence. The mean follow-up period was 69.8 months after injury, and the follow-up status was obtained from a patient questionnaire or a telephone interview.

    Results

    6 (75%) of the P group had post-realignment stricture. However, 2 patients (25%) were considered to have mild strictures that were easily managed with a urethral sound, and 4 (50%) had more significant stricture that required visual internal urethrotomy (VIU). 2 (18%) of the A group needed only a sound and 4 (36%) were managed via VIU. 1 (13%) of the P group reported mild stress incontinence, but the patient did not need padding. 6 (75%) of the P group had no erectile dysfunction, 1 (13%) reported a decreased quality of erection that required only oral phosphodiesterase 5 inhibitor and 1 (13%) required intracavernosal injection therapy.

    Conclusions

    Endoscopic primary realignment of urethral injury is a simple, safe, rapid and nontraumatic technique. It reduces the incidence and extent of the complications such as stricture, erectile dysfunction and incontinence. Therefore, we recommend this endoscopic primary realignment for the initial management of posterior urethral injury, as well as for anterior urethral injury.

    Keywords
    Endoscopy; Urethra; Injury

    Tables

    Table 1
    Patient's characteristics

    Table 2
    Complications during 5 year after primary realignment

    Table 3
    Results of endoscopic primary realignment for prosterior urethral injury

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    MeSH Terms
    Constriction, Pathologic
    Cyclic Nucleotide Phosphodiesterases, Type 5
    Endoscopy
    Erectile Dysfunction
    Follow-Up Studies*
    Humans
    Incidence
    Interviews as Topic
    Male
    Questionnaires
    Urethra
    Urethral Stricture
    Metrics
    Share
    Tables
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