A novel stricture prevention technique in blunt urethral injury: A multi-center retrospective observational study
Purpose: Bulbar injury is the most common type of urethral injury. This study investigated the efficacy and safety of a novel technique, local urethral flushing, in preventing stricture formation after blunt bulbar urethra injuries. Materials and Methods: This retrospective study included 205 males...
| Main Authors: | , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Korean Urological Association
2022-01-01
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| Series: | Investigative and Clinical Urology |
| Subjects: | |
| Online Access: | https://icurology.org/pdf/10.4111/icu.20210189 |
| _version_ | 1819283480126685184 |
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| author | Yang Mi Jingyu Wang Jinfeng Wu Xiaopeng Wang Bin Yang Ruimin Ren Yangang Zhang Xiaobin Yuan Xuhui Zhang |
| author_facet | Yang Mi Jingyu Wang Jinfeng Wu Xiaopeng Wang Bin Yang Ruimin Ren Yangang Zhang Xiaobin Yuan Xuhui Zhang |
| author_sort | Yang Mi |
| collection | DOAJ |
| description | Purpose: Bulbar injury is the most common type of urethral injury. This study investigated the efficacy and safety of a novel technique, local urethral flushing, in preventing stricture formation after blunt bulbar urethra injuries.
Materials and Methods: This retrospective study included 205 males diagnosed with straddle injury-induced bulbar urethra injury at the Shanxi Bethune Hospital and First Hospital of Shanxi Medical University between January 2015 and January 2019. Patients were diagnosed by retrograde urethrography and classified as partial or complete urethral rupture according to the urethral integrity after injury. Complete urethral rupture patients received suprapubic cystostomy and received urethroplasty 3 months later. Patients with partial urethral rupture underwent endoscopic urethral realignment by cystoscopic guide-wire guided catheterization. Patients with both injury types were divided into 3 groups. The treatment groups received urethral flushing with 0.05% dexamethasone through a secondary ureteral catheter that locked at the urethral lesion. The blank control groups received normal saline. The negative control groups had only a single ureteral catheter placed. Patients were assessed for pain during catheterization, infection, and stenosis, and followed for at least 2 years.
Results: Stenosis rates and length were significantly reduced in the normal saline groups, and even further reduced in the dexamethasone groups. The negative control groups had significantly higher infection rates than patients in the dexamethasone or saline groups.
Conclusions: Local urethral flushing with dexamethasone could significantly decrease urethral stenosis rates and severity without increasing patients’ discomfort or infection risk. |
| first_indexed | 2024-12-24T01:32:09Z |
| format | Article |
| id | doaj.art-8124c1e8afc0404aa0a11571e4fd2866 |
| institution | Directory Open Access Journal |
| issn | 2466-0493 2466-054X |
| language | English |
| last_indexed | 2024-12-24T01:32:09Z |
| publishDate | 2022-01-01 |
| publisher | Korean Urological Association |
| record_format | Article |
| series | Investigative and Clinical Urology |
| spelling | doaj.art-8124c1e8afc0404aa0a11571e4fd28662022-12-21T17:22:19ZengKorean Urological AssociationInvestigative and Clinical Urology2466-04932466-054X2022-01-0163111812210.4111/icu.20210189A novel stricture prevention technique in blunt urethral injury: A multi-center retrospective observational studyYang Mi0https://orcid.org/0000-0003-3249-5282Jingyu Wang1https://orcid.org/0000-0002-7740-878XJinfeng Wu2https://orcid.org/0000-0002-5193-7683Xiaopeng Wang3https://orcid.org/0000-0003-1343-5823Bin Yang 4https://orcid.org/0000-0001-7628-5303Ruimin Ren5https://orcid.org/0000-0002-7062-368XYangang Zhang6https://orcid.org/0000-0002-6317-3166Xiaobin Yuan7https://orcid.org/0000-0002-0497-430XXuhui Zhang8https://orcid.org/0000-0003-3202-1159Department of Urology, Shanxi Bethune Hospital, Shanxi Academy of Medical Sciences, Taiyuan, Shanxi, China.Department of Urology, Shanxi Bethune Hospital, Shanxi Academy of Medical Sciences, Taiyuan, Shanxi, China.Department of Urology, Shanxi Bethune Hospital, Shanxi Academy of Medical Sciences, Taiyuan, Shanxi, China.Department of Anesthesiology, Shanxi Bethune Hospital, Shanxi Academy of Medical Sciences, Taiyuan, Shanxi, China.Department of Urology, Shanxi Bethune Hospital, Shanxi Academy of Medical Sciences, Taiyuan, Shanxi, China.Department of Urology, Shanxi Bethune Hospital, Shanxi Academy of Medical Sciences, Taiyuan, Shanxi, China.Department of Urology, Shanxi Bethune Hospital, Shanxi Academy of Medical Sciences, Taiyuan, Shanxi, China.Department of Urology, First Hospital of Shanxi Medical University, Taiyuan, Shanxi, China.Department of Urology, First Hospital of Shanxi Medical University, Taiyuan, Shanxi, China.Purpose: Bulbar injury is the most common type of urethral injury. This study investigated the efficacy and safety of a novel technique, local urethral flushing, in preventing stricture formation after blunt bulbar urethra injuries. Materials and Methods: This retrospective study included 205 males diagnosed with straddle injury-induced bulbar urethra injury at the Shanxi Bethune Hospital and First Hospital of Shanxi Medical University between January 2015 and January 2019. Patients were diagnosed by retrograde urethrography and classified as partial or complete urethral rupture according to the urethral integrity after injury. Complete urethral rupture patients received suprapubic cystostomy and received urethroplasty 3 months later. Patients with partial urethral rupture underwent endoscopic urethral realignment by cystoscopic guide-wire guided catheterization. Patients with both injury types were divided into 3 groups. The treatment groups received urethral flushing with 0.05% dexamethasone through a secondary ureteral catheter that locked at the urethral lesion. The blank control groups received normal saline. The negative control groups had only a single ureteral catheter placed. Patients were assessed for pain during catheterization, infection, and stenosis, and followed for at least 2 years. Results: Stenosis rates and length were significantly reduced in the normal saline groups, and even further reduced in the dexamethasone groups. The negative control groups had significantly higher infection rates than patients in the dexamethasone or saline groups. Conclusions: Local urethral flushing with dexamethasone could significantly decrease urethral stenosis rates and severity without increasing patients’ discomfort or infection risk.https://icurology.org/pdf/10.4111/icu.20210189blunt injurybulbar urethradexamethasonelocal urethral flushing |
| spellingShingle | Yang Mi Jingyu Wang Jinfeng Wu Xiaopeng Wang Bin Yang Ruimin Ren Yangang Zhang Xiaobin Yuan Xuhui Zhang A novel stricture prevention technique in blunt urethral injury: A multi-center retrospective observational study Investigative and Clinical Urology blunt injury bulbar urethra dexamethasone local urethral flushing |
| title | A novel stricture prevention technique in blunt urethral injury: A multi-center retrospective observational study |
| title_full | A novel stricture prevention technique in blunt urethral injury: A multi-center retrospective observational study |
| title_fullStr | A novel stricture prevention technique in blunt urethral injury: A multi-center retrospective observational study |
| title_full_unstemmed | A novel stricture prevention technique in blunt urethral injury: A multi-center retrospective observational study |
| title_short | A novel stricture prevention technique in blunt urethral injury: A multi-center retrospective observational study |
| title_sort | novel stricture prevention technique in blunt urethral injury a multi center retrospective observational study |
| topic | blunt injury bulbar urethra dexamethasone local urethral flushing |
| url | https://icurology.org/pdf/10.4111/icu.20210189 |
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