Cognitive and processing mode of urethral distraction defect associated with pelvic fracture: a nationwide survey in Chinese urologists / 中华泌尿外科杂志

ABSTRACT

Objective To survey cognitive and processing mode of urethral distraction defect associated with pelvic fracture (PFUDD) in China and hope to find a reasonable treatment scheme for (PFUDD).Methods From Jan 2011 to Dem 2015,a questionnaire on surgical treatment for PFUDD was sent to 286 Chinese consultant urologists in more than 56 comprehensive hospitals throughout the China.The investigation includes the age of urologsit,the type of hospital,the number of patients treated during the last 5years,operation mode and optional time to do the surgery,the selection of operation approach,evaluation of the treatment effect were analyzed.At same time,we also investigated the methods of 260 cases about PFUDD.Results The age of the urologist were 30-55 years old.Over the past five years,229 urologists had fewer than 10 patients diagnosed each year,and only 57 had 10 patients diagnosed each year.There were many different kinds of operation method,including urethral realignment 36 (14％),direct vision internal urethrotomy 121 (46％),internal urethrotomy plus laser 57 (22％),trans-perineal urethral anastomosis 46(18％).The success rates were 58％ (21/36),50％ (60/121),46％ (26/57),76％ (35/46)respectively.70％ (200/286) of specialists did an open exploration urethral realignment or cystostomy when patients were injured in 2-6 hours.28％ (80/286) of specialists did urethral realignment with endoscopic surgery.About 75％ (216/286) of specialists believed that the treatment of patients with posterior urethral atresia should follow the ladder principle.Minimally invasive methods at the start,including urethral dilation,direct vision internal urethrotomy was the first choice.They would prefer open surgery only after intial treatment failure.65％ (186/286) of doctors believed that the overall outcome of the surgery was moderated.Conclusions Urethral distraction defect associated with pelvic fracture (PFUDD) was rare to be done.The direct vision internal urethrotomy was the first choice for most of the urologists(75％).They considered the urethroplast only after the failure of initial mini-invasive surgery.Trans-perineal urethral anastomosis had the best results.