Primary Realignment of Posterior Urethral Rupture

• Main Authors: Parham Masoudi, Rashid Askari, Abdolaziz Khezri, Mehdi Salehipour
• Format: Article
• Language: English
• Published: Urology and Nephrology Research Center, Shahid Beheshti University of Medical Sciences 2005-04-01
• Series: Urology Journal
• Online Access: http://www.urologyjournal.org/index.php/uj/article/view/227/224

<p class="MsoTitle" style="margin: 14pt 0cm; line-height: normal; text-align: left;" align="left"><span style="font-family: Times New Roman;"><span style="font-size: 12pt; mso-bidi-font-family: Nazanin;"><strong>Introduction:</strong></span><span style="font-weight: normal; font-size: 12pt; mso-bidi-font-family: Nazanin;"> We report the results of treatment of posterior urethral rupture (PUR) by primary realignment with some modifications of the technique.</span></span></p><p class="MsoTitle" style="margin: 14pt 0cm; line-height: normal; text-align: left;" align="left"><span style="font-family: Times New Roman;"><span style="font-size: 12pt; mso-bidi-font-family: Nazanin;"><strong>Materials and Methods:</strong></span><span style="font-weight: normal; font-size: 12pt; mso-bidi-font-family: Nazanin;"> In this prospective study, 25 patients (mean age, 33.5 years; range, 18 to 70 years) in whom PUR had been proved underwent primary urethral realignment. All patients were evaluated postoperatively for urinary incontinence, erectile dysfunction, and urethral stricture. They were followed for a mean of 20 months (range, 9 to 27 months).</span></span></p><p class="MsoTitle" style="margin: 14pt 0cm; line-height: normal; text-align: left;" align="left"><span style="font-family: Times New Roman;"><span style="font-size: 12pt; mso-bidi-font-family: Nazanin;"><strong>Results: </strong></span><span style="font-weight: normal; font-size: 12pt; mso-bidi-font-family: Nazanin;">In 20 of 25 patients (80%), posterior urethral rupture was associated with pelvic fractures and in 2 (8%), bladder rupture also was present. None of the patients had urinary incontinence. Six patients (24%) had evidence of postoperative stricture that required urethral dilatation and/or direct vision internal urethrotomy in 2 or 3 procedures under local anesthesia. Erectile dysfunction (which all responded to sildenafil) was reported by 4 patients (16%) as a decreased quality of erection. </span></span></p><p class="MsoTitle" style="margin: 14pt 0cm; line-height: normal; text-align: left;" align="left"><span style="font-family: Times New Roman;"><span style="font-size: 12pt; mso-bidi-font-family: Nazanin;"><strong>Conclusion:</strong></span><span style="font-weight: normal; font-size: 12pt; mso-bidi-font-family: Nazanin;"> We believe that primary realignment of PUR is a simple procedure associated with low morbidity. It is recommended for patients who are stable and have no other significant intra-abdominal and pelvic organ injuries.</span></span></p>