Initial management of acute urethral injuries

Area of Science:

• Urology
• Trauma Surgery

Background:

• Acute urethral trauma presents a significant clinical challenge.
• Injuries can be anterior or posterior, with varying etiologies and severity.

Purpose of the Study:

• To analyze the characteristics and treatment outcomes of acute urethral trauma.
• To evaluate the effectiveness of dilatations and surgical interventions for urethral strictures.

Main Methods:

• Retrospective review of 30 cases of acute urethral trauma over 7 years.
• Classification of injuries into anterior and posterior types.
• Documentation of injury causes, treatment modalities, and follow-up results.

Main Results:

• 20 posterior and 10 anterior urethral injuries were identified, mostly partial ruptures.
• Road traffic accidents caused 75% of posterior injuries; 80% of anterior injuries were 'straddle' type.
• All patients, except one iatrogenic case, required dilatations for stricture, averaging 5 per patient; 2 cases needed urethroplasty.

Conclusions:

• Acute urethral trauma commonly results in strictures requiring prolonged management.
• Periodic dilatations are effective for most post-traumatic urethral strictures.
• Urethroplasty remains an option for refractory cases.