2016 Volume 30 Issue 4 Pages 424-430
Objectives : Deferred urethroplasty for pelvic fracture-related urethral injuries remains a clinical challenge, and we describe our experience of such procedures. Methods : A retrospective analysis of 58 patients who had undergone deferred urethroplasty for pelvic fracture-related urethral injuries. The patients were subjected to serial postoperative monitoring involving a questionnaire about their symptoms, uroflowmetry, and cystoscopy. Success was defined as no worsening of urinary flow and the absence of strictures on cystoscopy. Results : The patients' median age was 35 years (range : 11 to 74). The median urethral gap, which was estimated from urethrograms, was 20 mm (range : 5 to 50). The median duration of the follow-up period was 22 months (range : 7 to 89). All of the urethroplasties were performed via stricture excision and primary anastomosis, and no substitution procedures were required. Repair was performed via a perineal procedure in 54 cases (93.1%) and via a perineo-abdominal procedure in 4 cases (6.9%). Urethroplasty was successful in 52 of the patients (89.6%). Two of the 6 failed urethroplasties were salvaged with a perineo-abdominal procedure, resulting in a final success rate of 93.1%. The surgical complications included lower extremity compartment syndrome in 2 patients, scrotal hematoma in 3 patients, and a surgical site infection in 1 patient, and all of them were managed conservatively. Conclusions : Deferred posterior urethroplasty for pelvic fracture-related urethral injuries has a high success rate and causes few morbidities.
