Abstract
Objective
To compare the long-term outcomes of initial management of pelvic fracture urethral
injury (PFUI) in a large cohort of trauma patients undergoing urethral reconstruction.
Materials and Methods
119 patients underwent urethral reconstruction by a single surgeon for PFUI at our
center between 1998-2018. We compared initial PFUI management - primary realignment
vs suprapubic tube (SPT) insertion alone. Multivariable Cox proportional hazard analysis
was used to assess the association between primary intervention and the risk of having
a complication.
Results
PFUI was initially managed with primary realignment (57%) or SPT alone (43%). Ultimately,
all patients underwent a primary perineal urethral anastomosis after a median of 7
months (IQR: 5-14). Overall, 27 patients (23%) had 1 or more long-term complications
after a median 25 months (IQR:7-66), including urethral stricture, de novo erectile
dysfunction, and urinary incontinence. On multivariable analysis, initial PFUI management
did not predict for complications.
Conclusion
No difference was found in long-term outcomes after urethral reconstruction when comparing
initial PFUI management of primary realignment vs SPT insertion.
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Article info
Publication history
Published online: November 26, 2021
Accepted:
October 20,
2021
Received:
September 15,
2021
Footnotes
Financial Disclosure: Dr. Herschorn reports grants from Astellas Pharma Canada, during the conduct of the study; grants from CIHR, grants from Allergan, grants and other from AMI, other from Boston Scientific, other from Pfizer, outside the submitted work. All other authors have no competing interests to declare.
Identification
Copyright
© 2021 Elsevier Inc. All rights reserved.
