Pro: endoscopic realignment for pelvic fracture urethral injuries.

Transl Androl Urol

DMC Medical Group Urology, College of Osteopathic Medicine, Michigan State University, Detroit, MI 48201, USA.

Published: February 2015

Patients with pelvic fracture urethral distraction injuries may benefit from early endoscopic realignment. Realignment is associated with a low risk of immediate complications and has a high success rate for achieving catheter placement. Review of over thirty studies assessing for subsequent urethral stenosis, including at least a dozen that directly compare realignment to suprapubic diversion along, conclude that there is a benefit averaging at least 35% in favor of realignment. Furthermore, realignment may result in easier subsequent urethroplasty and possibly shorter stenoses.

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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4708271PMC
http://dx.doi.org/10.3978/j.issn.2223-4683.2015.01.11DOI Listing

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Background: The management of pediatric patients afflicted with pelvic fracture urethral injury (PFUI) remains a topic of ongoing debate and controversy within the realm of urology. There is persistent discourse concerning the optimal timing for intervention, specifically between immediate primary realignment (PR) and delayed urethroplasty via suprapubic cystostomy (SCDU). This study was undertaken with the objective of conducting a systematic review of the existing body of evidence, with a focus on comparing the outcomes associated with PR and SCDU as interventions for PFUI among pediatric population.

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Pelvic fracture (PF) is a rare emergency, which led to pelvic fracture urethral injury (PFUI) in 1.6% to 25% of cases. Urethral injury assessment requires a thorough analysis of the initial injury history and imaging that combine cystourethrography acutely, repeat urethral imaging as well as adjunctive use of MRI in the follow-up period.

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