[Urethral disruption treated by echo guided endoscopic management: a case report]

Area of Science:

• Urology
• Minimally Invasive Surgery

Background:

• Straddle injuries can cause significant urethral disruption, leading to complications like urinary retention and bleeding.
• Traditional open urethral reconstruction can be invasive with potential complications.

Observation:

• A 63-year-old male presented with urinary retention and urethral meatal bleeding following a straddle injury.
• Urological examination identified a 1 cm gap in the proximal bulbous urethra, necessitating cystostomy placement.
• The urethral disruption was subsequently treated with echo-guided endoscopic urethroplasty.

Findings:

• Two sessions of transurethral resection of scar tissue were required to address postoperative urethral stricture.
• Postoperative voiding cystourethrography confirmed the absence of urethral stricture.
• The patient achieved successful voiding without urinary incontinence or erectile dysfunction.

Implications:

• Echo-guided endoscopic urethroplasty offers a minimally invasive, repeatable, and effective alternative to open surgery for urethral disruptions.
• The precise visualization provided by echo guidance facilitates accurate reconstruction of the urethral tract, minimizing risk to surrounding structures like the rectum.
• This approach holds promise for improving outcomes in managing traumatic urethral injuries.