요도 손상에 대한 내시경하 일차적 요도정렬술의 5년 추적 결과
5 Year Follow-up Results of Endoscopic Primary Realignment in Urethral Injury
박창수, 박성우, 김정만, 이정주,
소속 상세정보
박창수 ( Park Chang-Soo )
부산대학교 의과대학 비뇨기과학교실
박성우 ( Park Sung-Woo )
부산대학교 의과대학 비뇨기과학교실
김정만 ( Kim Jung-Man )
마산시 보건소
이정주 ( Lee Jeong-Zoo )
부산대학교 의과대학 비뇨기과학교실
KMID : 0358320070480111165
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
키워드
Endoscopy;Urethra;Injury
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