Does MRI help in the pre - operative evaluation of pelvic fracture urethral distraction defect? - a pilot study
Int. braz. j. urol
;
43(1): 127-133, Jan.-Feb. 2017. tab, graf
Artículo
en Inglés
| LILACS
| ID: biblio-840809
ABSTRACT
ABSTRACT Objectives To study the usefulness of MRI in preoperative evaluation of PFUDD. Can MRI provide additional information on urethral distraction defect (UDD) and cause of erectile dysfunction (ED)? Materials and Methods In this prospective study, consecutive male patients presenting with PFUDD were included from Feb 2011 till Dec 2012. Those with traumatic spinal cord injury and pre-existing ED were excluded. Patients were assessed using IIEF questionnaire, retrograde urethrogram and micturating cystourethrogram (RGU+MCU) and MRI pelvis. Primary end point was erectile function and secondary end point was surgical outcome. Results Twenty patients were included in this study. Fourteen patients (70%) were ≤40years; fifteen patients (75%) had ED, seven patients (35%) had severe ED. MRI findings associated with ED were longer median UDD (23mm vs. 15mm, p=0.07), cavernosal injury (100%, p=0.53), rectal injury (100%, p=0.53), retropubic scarring (60%, p=0.62) and prostatic displacement (60%, p=0.99). Twelve patients (60%) had a good surgical outcome, five (25%) had an acceptable outcome, three (15%) had a poor outcome. Poor surgical outcome was associated with rectal injury (66.7%, p=0.08), cavernosal injury (25%, p=0.19), retropubic scarring (18.1%, p=0.99) and prostatic displacement (16.7%, p=0.99). Five patients with normal erections had good surgical outcome. Three patients with ED had poor outcome (20%, p=0.20). Conclusions MRI did not offer significant advantage over MCU in the subgroup of men with normal erections. Cavernosal injury noted on MRI strongly correlated with ED. Role of MRI may be limited to the subgroup with ED or an inconclusive MCU.
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Índice:
LILACS (Américas)
Asunto principal:
Pelvis
/
Uretra
/
Enfermedades Uretrales
/
Imagen por Resonancia Magnética
/
Disfunción Eréctil
Tipo de estudio:
Estudio diagnóstico
/
Estudio de etiología
/
Estudio observacional
/
Factores de riesgo
Límite:
Adolescente
/
Adulto
/
Humanos
/
Masculino
Idioma:
Inglés
Revista:
Int. braz. j. urol
Asunto de la revista:
Urología
Año:
2017
Tipo del documento:
Artículo
País de afiliación:
India
Institución/País de afiliación:
Christian Medical College and Hospital/IN
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