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Evaluating functional outcomes of urethroplasty for complete post-traumatic rupture of the posterior urethra
Kays Chaker1, Ahmed Chaabouni2, Boutheina Mosbahi3
1Department of Urology, La Rabta Hospital, Tunis, Tunisia.
Insights
Delayed urethroplasty is effective for post-traumatic posterior urethral rupture, with 67% achieving satisfactory voiding. However, severe erectile dysfunction remains a significant concern following this procedure.
Area of Science:
- Urology
- Trauma Surgery
- Reconstructive Surgery
Background:
- Post-traumatic posterior urethral rupture is a severe injury impacting urinary and sexual function in young males.
- Delayed urethroplasty following suprapubic catheterization is a standard treatment approach.
Purpose of the Study:
- To evaluate urinary and sexual outcomes after delayed urethroplasty for complete post-traumatic posterior urethral rupture.
Main Methods:
- Retrospective multicentric study of patients undergoing urethroplasty (2014-2024) for complete posterior urethral rupture.
- Collection of preoperative, perioperative, and postoperative data, including complications, stenosis, incontinence, and erectile dysfunction.
Main Results:
- 42 patients (mean age 33) were analyzed with a median follow-up of 42 months.
- Satisfactory voiding achieved in 67% of patients; 22% required internal urethrotomy, and 7% had stress urinary incontinence.
- Median International Prostate Symptom Score (IPSS) was 6; median International Index of Erectile Function (IIEF-5) score was 16, indicating significant erectile dysfunction in a substantial proportion.
Conclusions:
- Urethroplasty is the preferred treatment for complete traumatic posterior urethral rupture.
- High rates of severe erectile dysfunction necessitate further investigation and management strategies.
Introduction:
Post-traumatic posterior urethral rupture is a severe injury that may significantly affect the urinary and sexual outcome in predominantly young patients. Delayed urethroplasty after suprapubic catheterization remains a preferred approach and part of the urologist's therapeutic arsenal. The objective of our study was to report the urinary and sexual outcomes after delayed urethroplasty for complete post-traumatic rupture of the posterior urethra.
Patients And Methods:
This is a retrospective multicentric study including all patients who underwent urethroplasty between 2014 and 2024 for complete post-traumatic rupture of the posterior urethra. Preoperative, perioperative, and postoperative outcome data were collected. Complications for the surgical procedure were analyzed, as well as postoperative stenosis, urinary incontinence and erectile dysfunction.
Results:
Forty-two patients were identified. The mean age was 33±10 years. In these patients, the mean postoperative bladder catheterization time was 20±4 days. The median postoperative follow- up period of 42 [24-64] months. Satisfactory voiding was noted in 28 patients (67%). The median IPSS score at the date of last news was 6 [0-22]. Internal urethrotomy following surgery was performed in night patients (22%), while three patients (7%) were treated for stress urinary incontinence. Five patients (12%) required a secondary urethroplasty. The median IIEF-5 score at the date of last news was 16 [15-19].
Conclusion:
We therefore consider urethroplasty as the treatment of choice for complete traumatic posterior urethral rupture. However, there is a high rate of severe erectile dysfunction after urethroplasty urethroplasty for complete post-traumatic rupture of the posterior urethra.
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