Application of ureteroscope in the diagnosis and treatment of male urethral injury

CAI Hai-jian; ZHOU Hong; DAI Jun; HE Hong-chao; HUANG Xin; SUN Fu-kang; SHEN Zhou-jun

doi:10.3969/j.issn.1009-4237.2013.06.009

Abstract：Objective To investigate the application of ureteroscope in the diagnosis and treatment of male urethral injury.Methods A retrospective analysis was performed in 65 males with urethral injury from Jan.2002 to Dec.2011.The type of injury,causes of trauma,severity,surgical methods,treatment and follow-up were re-viewed.Patients were divided into 2 groups according to the surgical method .Early supraubic cystostomy with de-layed urethroplasty was performed in 29 cases(Group A),while ureteroscopic-assisted catheterization or realignment was performed in 36 patients (Group B).Results In Group A,anterior urethral injury was demonstrated in 19 ca-ses (including 15 cases of urethral rupture and 4 cases of disruption),while posterior urethral injury was diagnosed in 10 cases (4 cases of rupture and 6 cases of disruption).In Group B,anterior urethral injury was demonstrated in 28 cases (including 24 cases of rupture and 4 cases of disruption),while posterior urethral injury was diagnosed in 8 cases (3 cases of rupture and 5 cases of disruption).The operative time in Group B was (17 ±11) minutes, which was significantly shorter than that in Group A (65 ±17)minutes.The formation of urethral stricture in Group B was significantly lower than that in Group A (11.1%vs.31.0%).But no statistical significance was observed in intra-operative blood loss and urinary peak flow rate between the two groups .Conclusion Ureteroscopic tech-nique is reliable and safe in the diagnosis and treatment of male urethral injury ,especially in patients combined with pelvic fracture.Ureteroscopic-assisted catheter placement and dual -endoscopic urethral realignment are easy to op-erate, and can restore the continuity of urethra in a short time under direct vision .