A Clinical Survey of Urethral Injury

Choi, In; Kim, Dong Han

Abstract

Despite of proper managements for injury, various kinds of complication still remain in urethral injury. And, urethral stricture, one of complication cases, is not yet resolved completely. Moreover, various kinds and different degrees of sequels have been reported in accordance with the choice for initial treatment. Therefore, proper selection of initial management methods is very important to prognosticate the patients. A clinical survey was made on 86 cases of urethral injury at the Dept. of Urology. Hanyang University Hospital, during the 10 years period from May 1972 to April 1982. The following results were obtained: 1. The probability of urethral injury was 36.2% of total genitourinary tract injury, and the most common combined injury was pelvic fracture. 2. The common age group of urethral injury was form 20's to 40's, and the rate of male to female was 27.3:1. 3. The common cause of urethral injury was the traffic accident (41.2%), and the common clinical symptom was external urethral bleeding (75.3%). 4. By the retrograde urethrogram, the common injury site was posterior urethra (62.2%), and the complete rupture was more frequent than incomplete. 5. Of 38 cases that the urethral catheter was inserted immediately after injured. 36 cases were satisfactory but two were impotent. 6. In the anterior urethral injury that was not indwelled the urethral catheter immediately, of 4 cases treated with suprapubic cystostomy 3 voided spontaneously, the other with endourethral urethroplasty as delayed realignment. But of 8 cases treated with interlocking sound, urethral stricture occurred in 3 cases and urethrocutaneous fistula in 2. 7. In the posterior urethral injury, of 21 cases treated with interlocking sound, fistula occurred in 6 cases, urethral stricture and impotence in 2 cases each. Of 10 cases treated with suprapubic cystostomy and delayed realignment, urethral stricture occurred in 3 cases and incontinence in one. 8. The rate of urethral stricture was less in steroid use than in not.