Bladder neck reconstruction in girls’ pelvic fracture bladder neck avulsion and urethral rupture
Abstract Background Girls’ pelvic fracture bladder neck avulsion and urethral rupture is rare however it causes great morbidity. The management is complex and not standard yet. We report our experience and a technique of bladder neck reconstruction with anterior bladder wall flap. Methods We retrosp...
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| Format: | Article |
| Language: | English |
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BMC
2020-11-01
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| Series: | BMC Urology |
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| Online Access: | http://link.springer.com/article/10.1186/s12894-020-00741-z |
| _version_ | 1818317728544456704 |
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| author | Rong Lv Chongrui Jin Huiquan Shu Lin Wang Yinglong Sa |
| author_facet | Rong Lv Chongrui Jin Huiquan Shu Lin Wang Yinglong Sa |
| author_sort | Rong Lv |
| collection | DOAJ |
| description | Abstract Background Girls’ pelvic fracture bladder neck avulsion and urethral rupture is rare however it causes great morbidity. The management is complex and not standard yet. We report our experience and a technique of bladder neck reconstruction with anterior bladder wall flap. Methods We retrospectively analysed data of 5 girls with pelvic fracture bladder neck avulsion and urethral rupture admitted to our institution from July 2017 to October 2019. They all came to our institution with a suprapubic tube. Patients’ trauma was all initially treated at other hospitals, 4 had suprapubic cystotomy and 1 had urethral realignment. One girl also had three other urethroplasties at other hospitals. We took pubectomy, posterior ureth roplasty and bladder neck reconstruction with anterior bladder wall flap in these 5 girls. Post-operative assessments included voiding cystourethrography, uroflowmetry and urethroscopy after urethral catheter removal. Verbal consent to participate was obtained from the parent or legal guardian of the children. Results Operation time ranged from 120 to 180 min. Follow-up time is 12 to 27 months. Uroflowmetry showed that maximum urine flow rate improved significantly. Cystourethrography indicated good continuity of the urethra. Two girls had urinary incontinence postoperatively but were continent 3 months later. One patient developed vesical-abdominal fistula and got repaired by surgery 6 months later. She was continent ever since. Other complications were not observed during the follow-up period. Conclusions Our method of bladder neck reconstruction using bladder flap as a patch is feasible and provides good continence, especially for those with serious bladder neck avulsion and urethral rupture caused by extensive trauma and those who had posttraumatic urethral distraction needed second repair. |
| first_indexed | 2024-12-13T09:41:56Z |
| format | Article |
| id | doaj.art-873a2fc193e84fe983033ee135f1d5c8 |
| institution | Directory Open Access Journal |
| issn | 1471-2490 |
| language | English |
| last_indexed | 2024-12-13T09:41:56Z |
| publishDate | 2020-11-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Urology |
| spelling | doaj.art-873a2fc193e84fe983033ee135f1d5c82022-12-21T23:52:10ZengBMCBMC Urology1471-24902020-11-012011610.1186/s12894-020-00741-zBladder neck reconstruction in girls’ pelvic fracture bladder neck avulsion and urethral ruptureRong Lv0Chongrui Jin1Huiquan Shu2Lin Wang3Yinglong Sa4Department of Urology, Shanghai Jiao Tong University Affiliated Sixth People’s HospitalDepartment of Urology, Shanghai Jiao Tong University Affiliated Sixth People’s HospitalDepartment of Urology, Shanghai Jiao Tong University Affiliated Sixth People’s HospitalDepartment of Urology, Shanghai Jiao Tong University Affiliated Sixth People’s HospitalDepartment of Urology, Shanghai Jiao Tong University Affiliated Sixth People’s HospitalAbstract Background Girls’ pelvic fracture bladder neck avulsion and urethral rupture is rare however it causes great morbidity. The management is complex and not standard yet. We report our experience and a technique of bladder neck reconstruction with anterior bladder wall flap. Methods We retrospectively analysed data of 5 girls with pelvic fracture bladder neck avulsion and urethral rupture admitted to our institution from July 2017 to October 2019. They all came to our institution with a suprapubic tube. Patients’ trauma was all initially treated at other hospitals, 4 had suprapubic cystotomy and 1 had urethral realignment. One girl also had three other urethroplasties at other hospitals. We took pubectomy, posterior ureth roplasty and bladder neck reconstruction with anterior bladder wall flap in these 5 girls. Post-operative assessments included voiding cystourethrography, uroflowmetry and urethroscopy after urethral catheter removal. Verbal consent to participate was obtained from the parent or legal guardian of the children. Results Operation time ranged from 120 to 180 min. Follow-up time is 12 to 27 months. Uroflowmetry showed that maximum urine flow rate improved significantly. Cystourethrography indicated good continuity of the urethra. Two girls had urinary incontinence postoperatively but were continent 3 months later. One patient developed vesical-abdominal fistula and got repaired by surgery 6 months later. She was continent ever since. Other complications were not observed during the follow-up period. Conclusions Our method of bladder neck reconstruction using bladder flap as a patch is feasible and provides good continence, especially for those with serious bladder neck avulsion and urethral rupture caused by extensive trauma and those who had posttraumatic urethral distraction needed second repair.http://link.springer.com/article/10.1186/s12894-020-00741-zFemale pediatric urethral injuryBladder neck reconstructionUrinary continencePediatric pelvic trauma |
| spellingShingle | Rong Lv Chongrui Jin Huiquan Shu Lin Wang Yinglong Sa Bladder neck reconstruction in girls’ pelvic fracture bladder neck avulsion and urethral rupture BMC Urology Female pediatric urethral injury Bladder neck reconstruction Urinary continence Pediatric pelvic trauma |
| title | Bladder neck reconstruction in girls’ pelvic fracture bladder neck avulsion and urethral rupture |
| title_full | Bladder neck reconstruction in girls’ pelvic fracture bladder neck avulsion and urethral rupture |
| title_fullStr | Bladder neck reconstruction in girls’ pelvic fracture bladder neck avulsion and urethral rupture |
| title_full_unstemmed | Bladder neck reconstruction in girls’ pelvic fracture bladder neck avulsion and urethral rupture |
| title_short | Bladder neck reconstruction in girls’ pelvic fracture bladder neck avulsion and urethral rupture |
| title_sort | bladder neck reconstruction in girls pelvic fracture bladder neck avulsion and urethral rupture |
| topic | Female pediatric urethral injury Bladder neck reconstruction Urinary continence Pediatric pelvic trauma |
| url | http://link.springer.com/article/10.1186/s12894-020-00741-z |
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