Primary realignment of posterior urethral rupture

Area of Science:

• Urology
• Trauma Surgery
• Reconstructive Urology

Background:

• Posterior urethral rupture (PUR) is a severe injury often associated with pelvic trauma.
• Traditional treatments for PUR can lead to significant morbidity, including incontinence and erectile dysfunction.

Purpose of the Study:

• To evaluate the efficacy and safety of primary urethral realignment with modified techniques for treating posterior urethral rupture.
• To assess postoperative outcomes, including urinary incontinence, erectile dysfunction, and urethral stricture.

Main Methods:

• A prospective study involving 25 male patients with confirmed PUR.
• All patients underwent primary urethral realignment with modified surgical techniques.
• Postoperative evaluation included assessments for urinary incontinence, erectile dysfunction, and urethral stricture, with a mean follow-up of 20 months.

Main Results:

• 80% of PUR cases were associated with pelvic fractures; 8% also had bladder rupture.
• No patients experienced urinary incontinence postoperatively.
• 24% developed urethral strictures requiring intervention; 16% reported erectile dysfunction, responsive to sildenafil.

Conclusions:

• Primary realignment of posterior urethral rupture is a straightforward procedure with low complication rates.
• This technique is recommended for hemodynamically stable patients without severe associated intra-abdominal or pelvic injuries.