Journal of Trauma and Injury

  • 제36권2호
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  • Pages.161-164
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  • 2023
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  • 2799-4317(pISSN)
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  • 2287-1683(eISSN)
대한외상학회 (The Korean Society of Traumatology)
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Spontaneous recanalization of complete urethral injury treated by suprapubic cystostomy alone after severe pelvic bone fracture in a young male patient in Korea: a case report

  • Han Kyul Shin (Department of Trauma Surgery, Armed Forces Trauma Center, Armed Forces Capital Hospital) ;
  • Gi Ho Moon (Department of Trauma Surgery, Armed Forces Trauma Center, Armed Forces Capital Hospital) ;
  • Sung Yub Jeong (Department of Trauma Surgery, Armed Forces Trauma Center, Armed Forces Capital Hospital) ;
  • Ho Jun Lee (Department of Trauma Surgery, Armed Forces Trauma Center, Armed Forces Capital Hospital)
  • 투고 : 2022.09.28
  • 심사 : 2022.11.09
  • 발행 : 2023.06.30
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초록

Injury to the genitourinary tract is rare, with an incidence of less than 1%. Younger men (mean age, approximately 30 years) are predominantly affected. We introduce an unusual case of a 25-year-old male patient with complete urethral injury combined with a severe open pelvic bone fracture. During the emergency surgery, the primary realignment of the posterior urethra could not be performed due to a large defect. With suprapubic cystostomy alone, follow-up voiding cystourethrography showed spontaneous recanalization of the transected urethra after four months. Suprapubic cystostomy is an efficient treatment option when primary realignment is not possible.

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참고문헌

  1. Bjurlin MA, Fantus RJ, Mellett MM, Goble SM. Genitourinary injuries in pelvic fracture morbidity and mortality using the National Trauma Data Bank. J Trauma 2009;67:1033-9. https://doi.org/10.1097/TA.0b013e3181bb8d6c
  2. Koraitim MM. Pelvic fracture urethral injuries: evaluation of various methods of management. J Urol 1996;156:1288-91. https://doi.org/10.1016/S0022-5347(01)65571-X
  3. Myers JB, McAninch JW. Management of posterior urethral disruption injuries. Nat Clin Pract Urol 2009;6:154-63.
  4. Koraitim MM. Pelvic fracture urethral injuries: the unresolved controversy. J Urol 1999;161:1433-41. https://doi.org/10.1016/S0022-5347(05)68918-5
  5. Badenoch AW. A pull-through operation for impassable traumatic stricture of the urethra. Br J Urol 1950;22:404-9. https://doi.org/10.1111/j.1464-410X.1950.tb02547.x
  6. Morehouse DD, Belitsky P, Mackinnon K. Rupture of the posterior urethra. J Urol 1972;107:255-8. https://doi.org/10.1016/S0022-5347(17)60996-0
  7. Waterhouse K, Laungani G, Patil U. The surgical repair of membranous urethral strictures: experience with 105 consecutive cases. J Urol 1980;123:500-5. https://doi.org/10.1016/S0022-5347(17)55990-X
  8. Flynn BJ, Delvecchio FC, Webster GD. Perineal repair of pelvic fracture urethral distraction defects: experience in 120 patients during the last 10 years. J Urol 2003;170:1877-80. https://doi.org/10.1097/01.ju.0000091642.41368.f5
  9. Wessells H, Angermeier KW, Elliott S, et al. Male urethral stricture: American Urological Association Guideline. J Urol 2017;197:182-90. https://doi.org/10.1016/j.juro.2016.07.087
  10. Barrett K, Braga LH, Farrokhyar F, Davies TO. Primary realignment vs suprapubic cystostomy for the management of pelvic fracture-associated urethral injuries: a systematic review and meta-analysis. Urology 2014;83:924-9. https://doi.org/10.1016/j.urology.2013.12.031
  11. Mouraviev VB, Coburn M, Santucci RA. The treatment of posterior urethral disruption associated with pelvic fractures: comparative experience of early realignment versus delayed urethroplasty. J Urol 2005;173:873-6. https://doi.org/10.1097/01.ju.0000152145.33215.36
  12. Chang PC, Hsu YC, Shee JJ, et al. Early endoscopic primary realignment decreases stricture formation and reduces medical costs in traumatic complete posterior urethral disruption in a 2-year follow-up. Chang Gung Med J 2011;34:179-85.
  13. Moudouni SM, Patard JJ, Manunta A, Guiraud P, Lobel B, Guille F. Early endoscopic realignment of post-traumatic posterior urethral disruption. Urology 2001;57:628-32. https://doi.org/10.1016/S0090-4295(00)01068-2
  14. Light A, Gupta T, Dadabhoy M, et al. Outcomes following primary realignment versus suprapubic cystostomy with delayed urethroplasty for pelvic fracture-associated posterior urethral injury: a systematic review with meta-analysis. Curr Urol 2019;13:113-24. https://doi.org/10.1159/000499282
  15. Morey AF, Broghammer JA, Hollowell CM, McKibben MJ, Souter L. Urotrauma Guideline 2020: AUA Guideline. J Urol 2021;205:30-5. https://doi.org/10.1097/JU.0000000000001408