Introduction and Objectives
Urethral injury may be due to a variety of causes. Key point in the management is to diagnose a total or partial rupture. Our aim is to study if the mechanism of injury can prejudge partial or total urethral rupture. Urethral injury may cause complications, short-term (acute urinary retention) or longterm (strictures, incontinence, erectile dysfunction)
Material and Methods
A retrospective study of 83 patients presented with traumatic urethral rupture from January 2005 until June 2008. All patients underwent retrograde urethrography after clinical, laboratory and radiographic examination. In case of diagnosis of contusion or partial rupture, a gentle effort to pass a urethral catheter was done. In all patients with total rupture and in these with partial rupture that the urethral catheterization attempt was unsuccessful, a suprapubic catheterization was performed followed by simultaneous cystography and retrograde urethrography. Delayed urethroplasty was performed in patients with total rupture. The mechanism of injury was correlated with total or partial rupture of the urethra.
Results
In 28 patients with injury of the posterior urethra with coexistent pelvic ring fractures, total rupture occurred in sixteen (16) while partial rupture in twelve (12). In 55 patients with injury of the anterior urethra we diagnosed:
Tabled
1
| Mechanism of injury | Total rupture of urethra | Partial rupture of urethra |
|---|---|---|
| Iatrogenic injuries | 2 | 32 |
| Blunt trauma | 4 | 6 |
| Penetrating injuries | 4 | 3 |
| Penile fractures | 0 | 4 |
Conclusions
From our experience, mechanism of injury cannot prejudge partial or total urethral rupture, except in the case of iatrogenic injuries. Each patient should be assessed and managed according to the basic diagnostic algorithm.
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Copyright
© 2009 European Association of Urology. Published by Elsevier Inc. All rights reserved.
