Comparison of Immediate Primary Repair and Delayed Urethroplasty in Men with Bulbous Urethral Disruption after Blunt Straddle Injury
공인혁, 오종진, Choi Don-Kyung, 황진호, 강문형, Lee Young-Tea,
소속 상세정보
공인혁 ( Gong In-Hyuck )
CHA University CHA Bundang Medical Center Department of Urology
오종진 ( Oh Jong-Jin )
CHA University CHA Bundang Medical Center Department of Urology
( Choi Don-Kyung )
CHA University CHA Bundang Medical Center Department of Urology
황진호 ( Hwang Jin-Ho )
CHA University CHA Bundang Medical Center Department of Urology
강문형 ( Kang Moon-Hyung )
CHA University CHA Bundang Medical Center Department of Urology
( Lee Young-Tea )
CHA University CHA Bundang Medical Center Department of Urology
KMID : 0358320120530080569
Abstract
Purpose: The aim of this study was to analyze the outcomes of immediate primary repair (IPR) compared with delayed repair (DR) after initial suprapubic cystostomy.
Materials and Methods: We reviewed the records of 60 patients with bulbous urethral disruption after blunt trauma from February 2001 to March 2011. Seventeen patients who presented in an acute injury state underwent IPR; 43 patients underwent DR after the initial suprapubic cystostomy. None of the patients had undergone previous urethral manipulation. We compared the outcomes, including stricture, impotence, and incontinence, between the two management approaches. We also measured the time to spontaneous voiding, the duration of suprapubic diversion, and the number of days spent in the hospital.
Results: The median follow-up was 20.5 months (range, 13 to 59 months; mean, 23.3 months). Among 17 patients in the IPR group, strictures developed in 2 patients (11.7%), and among 53 patients in the DR group, strictures developed in 8 patients (18.6%, p=0.709). The incidences of impotence and incontinence were similar in both groups (17.6% and 0% in the IPR group vs. 27.9% and 4.6% in the DR group, p=0.520 and 1.000, respectively). The time to spontaneous voiding and the duration of suprapubic diversion were significantly shorter in the IPR group (average 27.3 and 33.4 days, respectively) than in the DR group (average 191.6 and 198.1 days, respectively; p<0.001 and <0.001).
Conclusions: IPR may provide comparable outcomes to DR and allow for shorter times to spontaneous voiding and reduce the duration of suprapubic diversion.
키워드
Urethra; Urethral stricture; Urologic surgical procedures; Wounds and injuries
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