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

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.