Treatment of male urethral trauma is always a challenging problem.In China,as the incidence of urethral trauma keeps rising,more and more studies relating to this are being published.To compare the outcome of differen...Treatment of male urethral trauma is always a challenging problem.In China,as the incidence of urethral trauma keeps rising,more and more studies relating to this are being published.To compare the outcome of different emergency treatments in China and other countries,we searched Chinese and English literature about this topic in the past 16 years.A total of 167 studies involving 5314 patients were included,with 144 in Chinese and 23 in English.All studies were retrospective in nature.Based on the analyses,surgical methods include open realignment,endoscopic realignment and primary repair,and we summarized and compared the success rate and complications(mainly erectile dysfunction and incontinence)of each method.We found that realignment of posterior urethra has similar success rate in China and other countries,but the outcome of realignment of anterior urethra is variable.The reason remains unknown.While long abandoned in Western countries,primary repair of anterior urethra is still an option in China and has high success rate.展开更多
Background:Although urethral trauma may lead to serious consequences if mismanaged,treatment concepts are inconsistent.We designed a survey to investigate the current diagnosis and management of emergency blunt urethr...Background:Although urethral trauma may lead to serious consequences if mismanaged,treatment concepts are inconsistent.We designed a survey to investigate the current diagnosis and management of emergency blunt urethral trauma to aid future dissemination of relevant concepts.Methods:A 15‐item anonymous questionnaire was distributed via an online platform.It addressed items such as the cognition of how to diagnose of urethral trauma,optimal emergency management of a urethral trauma patient,and attitude towards early realignment for pelvic fracture urethral injuries.Results:Of 538 respondents,94.2%and 84.9%had received patients with straddle trauma urethral injuries or pelvic fracture urethral injuries,respectively,within the past year.In the emergency room,attempted urethral catheterization was the most selected examination method by respondents for diagnosis of both straddle injury(500/538)and pelvic fracture urethral injury(469/538).For patients with straddle injury,41.3%of respondents performed endoscopic realignment and 31.6%preferred suprapubic cystostomy.For hemodynamically stable patients with PFUI,42.2%of respondents preferred suprapubic cystostomy and 34.9%preferred endoscopic realignment.Most respondents felt favorably toward early realignment for pelvic fracture urethral injuries.After realignment,61.3%,24.5%,and 13.8%of respondents performed catheterization for 4,8,and 12 weeks,respectively.Further,54.6%of respondents believed catheter traction should be applied after realignment.Conclusion:Although the number of yearly emergency urethral trauma cases was small,the opinions and practices of most urologists were consistent with guidelines.However,the significance of retrograde urethrography was not fully understood,and some respondents had incorrect views on catheter traction after realignment.展开更多
文摘Treatment of male urethral trauma is always a challenging problem.In China,as the incidence of urethral trauma keeps rising,more and more studies relating to this are being published.To compare the outcome of different emergency treatments in China and other countries,we searched Chinese and English literature about this topic in the past 16 years.A total of 167 studies involving 5314 patients were included,with 144 in Chinese and 23 in English.All studies were retrospective in nature.Based on the analyses,surgical methods include open realignment,endoscopic realignment and primary repair,and we summarized and compared the success rate and complications(mainly erectile dysfunction and incontinence)of each method.We found that realignment of posterior urethra has similar success rate in China and other countries,but the outcome of realignment of anterior urethra is variable.The reason remains unknown.While long abandoned in Western countries,primary repair of anterior urethra is still an option in China and has high success rate.
文摘Background:Although urethral trauma may lead to serious consequences if mismanaged,treatment concepts are inconsistent.We designed a survey to investigate the current diagnosis and management of emergency blunt urethral trauma to aid future dissemination of relevant concepts.Methods:A 15‐item anonymous questionnaire was distributed via an online platform.It addressed items such as the cognition of how to diagnose of urethral trauma,optimal emergency management of a urethral trauma patient,and attitude towards early realignment for pelvic fracture urethral injuries.Results:Of 538 respondents,94.2%and 84.9%had received patients with straddle trauma urethral injuries or pelvic fracture urethral injuries,respectively,within the past year.In the emergency room,attempted urethral catheterization was the most selected examination method by respondents for diagnosis of both straddle injury(500/538)and pelvic fracture urethral injury(469/538).For patients with straddle injury,41.3%of respondents performed endoscopic realignment and 31.6%preferred suprapubic cystostomy.For hemodynamically stable patients with PFUI,42.2%of respondents preferred suprapubic cystostomy and 34.9%preferred endoscopic realignment.Most respondents felt favorably toward early realignment for pelvic fracture urethral injuries.After realignment,61.3%,24.5%,and 13.8%of respondents performed catheterization for 4,8,and 12 weeks,respectively.Further,54.6%of respondents believed catheter traction should be applied after realignment.Conclusion:Although the number of yearly emergency urethral trauma cases was small,the opinions and practices of most urologists were consistent with guidelines.However,the significance of retrograde urethrography was not fully understood,and some respondents had incorrect views on catheter traction after realignment.
