Urethral Pull-through Operation for the Management of Pelvic Fracture Urethral Distraction Defects

作者：Yin, Lei; Li, Zhenhua; Kong, Chuize^*; Yu, Xiuyue; Zhu, Yuyan; Zhang, Yuxi; Jiang, Yuanjun

来源：Urology, 2011, 78(4): 946-950.

DOI：10.1016/j.urology.2011.05.027

• POSTERIOR URETHROPLASTY
• RECONSTRUCTION
• DISRUPTION
• EXPERIENCE
• STRICTURE
• REPAIR

OBJECTIVE To present our institutional experience in the management of pelvic fracture urethral distraction defects with urethral pull-through operation.
METHODS Seventy-six patients (average age 34.5 years) with posterior urethral strictures caused by pelvic fracture urethral distraction defects underwent urethral pull-through operation at our department from July 1995 to September 2009. The estimated urethral stricture length was 2.0-3.5 cm (mean 2.5). Of these patients, 31 (41%) had undergone failed urethroplasty or urethrotomy after the initial management, and 5 (7%) had urethrorectal fistula. Urethral pull-through operation was performed 4-7 months (mean 4.9) after initial treatment or failed urethral reconstruction. The clinical outcome was considered a failure when any postoperative intervention was needed.
RESULTS Follow-up was 14-74 months (mean 42.5). The overall success rate was 89% (68/76). All treatment failures occurred within the first 6 months postoperatively. Failed repairs were successfully managed with internal urethrotomy in 1 patient, by urethral dilation in 6, and by another urethroplasty in 1. All patients were urinary-continent postoperatively. Of the potent patients, 2 (5%) became impotent after urethroplasty. There was no chordee, penile shortening, or urethral fistula recurrence.
CONCLUSION Urethral pull-through operation might be a less demanding and less time-consuming procedure. It does not increase the rate of impotence or incontinence and, with a high success rate, might serve as an alternative method for the management of pelvic fracture urethral distraction defects. UROLOGY 78: 946-951, 2011.

• 出版日期2011-10
• 单位中国医科大学