Analysis of anastomotic urethroplasty for pelvic fracture urethral distraction defect: Decadal experience from a high-volume tertiary care center
Context: Pelvic fracture urethral distraction defect (PFUDD) may be challenging for the treating urologist. Anastomotic urethroplasty is the established surgical procedure for the treatment of PFUDD. Few studies in literature focus purely on PFUDD, and majority of the studies include anterior urethr...
| Main Authors: | , , , |
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| Format: | Article |
| Language: | English |
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Wolters Kluwer Medknow Publications
2019-01-01
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| Series: | Urology Annals |
| Subjects: | |
| Online Access: | http://www.urologyannals.com/article.asp?issn=0974-7796;year=2019;volume=11;issue=1;spage=77;epage=82;aulast=Saini |
| _version_ | 1818984849921277952 |
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| author | Durgesh Kumar Saini Rahul Janak Sinha Ashok Kumar Sokhal Vishwajeet Singh |
| author_facet | Durgesh Kumar Saini Rahul Janak Sinha Ashok Kumar Sokhal Vishwajeet Singh |
| author_sort | Durgesh Kumar Saini |
| collection | DOAJ |
| description | Context: Pelvic fracture urethral distraction defect (PFUDD) may be challenging for the treating urologist. Anastomotic urethroplasty is the established surgical procedure for the treatment of PFUDD. Few studies in literature focus purely on PFUDD, and majority of the studies include anterior urethral stricture as well. The period of these studies is relatively short. We conducted a retrospective analysis of patients who underwent primary or redo anastomotic urethroplasty for PFUDD over a period of 12 years at a tertiary care center in northern India.
Aims: The aim is to study anastomotic urethroplasty for pelvic fracture urethral distraction defect with regard to long-term success rate and complications.
Settings and Design: This was a retrospective study. Subjects and
Methods: This retrospective study was conducted in the Department of Urology, King George's Medical University, Lucknow, India, from August 2004 to July 2016. All patients who underwent progressive perineal anastomotic repair of PFUDD were included in this study. Demographic findings, type of pelvic fracture, length of distraction defect as per retrograde urethrography (RUG) and micturating cystourethrography, any history of erectile dysfunction in the preoperative or postoperative phase, and urinary incontinence in postoperative phase were analyzed. Decision regarding catheter removal was taken after pericatheter RUG at 4 weeks. Follow-up was done at 3 and 6 months in postoperative period.
Results: A total of 226 anastomotic repairs were done in 221 patients. Of the 221 patients, 51 (23%) were redo urethroplasty. The mean age of patients was 27.6 years. The mean length of distraction defect was 2.7 cm. The mean duration of hospital stay was 6 days. Primary urethroplasty was successful in 163 (93.14%) of 175 patients and redo urethroplasty in 44 (86.27%) of 51 patients. Out of 165 patients, 18 (10.9%) patients reported occasional incontinence while 6 (3.63%) patients reported mild incontinence.
Conclusions: Anastomotic urethroplasty is the definitive procedure for PFUDD. Our success rate for primary deferred anastomotic urethroplasty is 93.14% and for redo anastomotic urethroplasty is 86.27%. |
| first_indexed | 2024-12-20T18:25:33Z |
| format | Article |
| id | doaj.art-4e6c2a957fd8459ba6833caad23da5b1 |
| institution | Directory Open Access Journal |
| issn | 0974-7796 0974-7834 |
| language | English |
| last_indexed | 2024-12-20T18:25:33Z |
| publishDate | 2019-01-01 |
| publisher | Wolters Kluwer Medknow Publications |
| record_format | Article |
| series | Urology Annals |
| spelling | doaj.art-4e6c2a957fd8459ba6833caad23da5b12022-12-21T19:30:09ZengWolters Kluwer Medknow PublicationsUrology Annals0974-77960974-78342019-01-01111778210.4103/UA.UA_48_17Analysis of anastomotic urethroplasty for pelvic fracture urethral distraction defect: Decadal experience from a high-volume tertiary care centerDurgesh Kumar SainiRahul Janak SinhaAshok Kumar SokhalVishwajeet SinghContext: Pelvic fracture urethral distraction defect (PFUDD) may be challenging for the treating urologist. Anastomotic urethroplasty is the established surgical procedure for the treatment of PFUDD. Few studies in literature focus purely on PFUDD, and majority of the studies include anterior urethral stricture as well. The period of these studies is relatively short. We conducted a retrospective analysis of patients who underwent primary or redo anastomotic urethroplasty for PFUDD over a period of 12 years at a tertiary care center in northern India. Aims: The aim is to study anastomotic urethroplasty for pelvic fracture urethral distraction defect with regard to long-term success rate and complications. Settings and Design: This was a retrospective study. Subjects and Methods: This retrospective study was conducted in the Department of Urology, King George's Medical University, Lucknow, India, from August 2004 to July 2016. All patients who underwent progressive perineal anastomotic repair of PFUDD were included in this study. Demographic findings, type of pelvic fracture, length of distraction defect as per retrograde urethrography (RUG) and micturating cystourethrography, any history of erectile dysfunction in the preoperative or postoperative phase, and urinary incontinence in postoperative phase were analyzed. Decision regarding catheter removal was taken after pericatheter RUG at 4 weeks. Follow-up was done at 3 and 6 months in postoperative period. Results: A total of 226 anastomotic repairs were done in 221 patients. Of the 221 patients, 51 (23%) were redo urethroplasty. The mean age of patients was 27.6 years. The mean length of distraction defect was 2.7 cm. The mean duration of hospital stay was 6 days. Primary urethroplasty was successful in 163 (93.14%) of 175 patients and redo urethroplasty in 44 (86.27%) of 51 patients. Out of 165 patients, 18 (10.9%) patients reported occasional incontinence while 6 (3.63%) patients reported mild incontinence. Conclusions: Anastomotic urethroplasty is the definitive procedure for PFUDD. Our success rate for primary deferred anastomotic urethroplasty is 93.14% and for redo anastomotic urethroplasty is 86.27%.http://www.urologyannals.com/article.asp?issn=0974-7796;year=2019;volume=11;issue=1;spage=77;epage=82;aulast=SainiPelvic fracture urethral distraction defectpelvic traumaperineal anastomotic urethroplastyposterior urethral injury |
| spellingShingle | Durgesh Kumar Saini Rahul Janak Sinha Ashok Kumar Sokhal Vishwajeet Singh Analysis of anastomotic urethroplasty for pelvic fracture urethral distraction defect: Decadal experience from a high-volume tertiary care center Urology Annals Pelvic fracture urethral distraction defect pelvic trauma perineal anastomotic urethroplasty posterior urethral injury |
| title | Analysis of anastomotic urethroplasty for pelvic fracture urethral distraction defect: Decadal experience from a high-volume tertiary care center |
| title_full | Analysis of anastomotic urethroplasty for pelvic fracture urethral distraction defect: Decadal experience from a high-volume tertiary care center |
| title_fullStr | Analysis of anastomotic urethroplasty for pelvic fracture urethral distraction defect: Decadal experience from a high-volume tertiary care center |
| title_full_unstemmed | Analysis of anastomotic urethroplasty for pelvic fracture urethral distraction defect: Decadal experience from a high-volume tertiary care center |
| title_short | Analysis of anastomotic urethroplasty for pelvic fracture urethral distraction defect: Decadal experience from a high-volume tertiary care center |
| title_sort | analysis of anastomotic urethroplasty for pelvic fracture urethral distraction defect decadal experience from a high volume tertiary care center |
| topic | Pelvic fracture urethral distraction defect pelvic trauma perineal anastomotic urethroplasty posterior urethral injury |
| url | http://www.urologyannals.com/article.asp?issn=0974-7796;year=2019;volume=11;issue=1;spage=77;epage=82;aulast=Saini |
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