A novel stricture prevention technique in blunt urethral injury: A multi-center retrospective observational study

Yang Mi; Jingyu Wang; Jinfeng Wu; Xiaopeng Wang; Bin Yang; Ruimin Ren; Yangang Zhang; Xiaobin Yuan; Xuhui Zhang

doi:https://doi.org/10.4111/icu.20210189

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자료유형: 학술저널

저자정보: Yang Mi (Shanxi Academy of Medical Sciences) Jingyu Wang (Shanxi Academy of Medical Sciences) Jinfeng Wu (Shanxi Academy of Medical Sciences) Xiaopeng Wang (Shanxi Academy of Medical Sciences) Bin Yang (Shanxi Academy of Medical Sciences) Ruimin Ren (Shanxi Academy of Medical Sciences) Yangang Zhang (Shanxi Academy of Medical Sciences) Xiaobin Yuan (First Hospital of Shanxi Medical University) Xuhui Zhang (First Hospital of Shanxi Medical University)

저널정보: 대한비뇨기과학회 Investigative and Clinical Urology Investigative and Clinical Urology Vol.63 No.1

발행연도: 2022.1

수록면: 118 - 122 (5page)

DOI: https://doi.org/10.4111/icu.20210189

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Purpose: Bulbar injury is the most common type of urethral injury. This study investigated the efficacy and safety of a novel technique, local urethral flushing, in preventing stricture formation after blunt bulbar urethra injuries. Materials and Methods: This retrospective study included 205 males diagnosed with straddle injury-induced bulbar urethra injury at the Shanxi Bethune Hospital and First Hospital of Shanxi Medical University between January 2015 and January 2019. Patients were diagnosed by retrograde urethrography and classified as partial or complete urethral rupture according to the urethral integrity after injury. Complete urethral rupture patients received suprapubic cystostomy and received urethroplasty 3 months later. Patients with partial urethral rupture underwent endoscopic urethral realignment by cystoscopic guide-wire guided catheterization. Patients with both injury types were divided into 3 groups. The treatment groups received urethral flushing with 0.05% dexamethasone through a secondary ureteral catheter that locked at the urethral lesion. The blank control groups received normal saline. The negative control groups had only a single ureteral catheter placed. Patients were assessed for pain during catheterization, infection, and stenosis, and followed for at least 2 years. Results: Stenosis rates and length were significantly reduced in the normal saline groups, and even further reduced in the dexamethasone groups. The negative control groups had significantly higher infection rates than patients in the dexamethasone or saline groups. Conclusions: Local urethral flushing with dexamethasone could significantly decrease urethral stenosis rates and severity without increasing patients’ discomfort or infection risk.

#Blunt injury #Bulbar urethra #Dexamethasone #Local urethral flushing

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