Clinical Observation of Skin Inlay Urethroplasty in 11 Cases of Posterior Urethral Injury

Lee, Jeong Hoon; Lim, Su Kil

Abstract

A clinical observation was made on 11 patients of posterior urethral injury who performed skin inlay urethroplasty in the Department of Urology, St. Mary`s Hospital, Catholic Medical College during the period from January, 1970 to December, 1983. The results were as follows: 1. Age distribution of these patients showed the highest range in the age 0-9 and 10-19(8 cases) 2. The most common cause of the posterior urethral injury was traffic accident.(9 cases), falling down accident (1 case) and blunt trauma (1 case). 3. The concomitant diseases at the time of urethral injury were pelvic bone fracture (9 cases), other bone fractures (3 cases), bladder rupture (2 case), other viscera injuries (2 cases) and retroperitoneal hematoma (1 case). 4. Involved sites of urethral injury were membranous urethra (9 cases) and bulbo-membranous junction (2 cases). 5. The previous procedures before skin inlay urethroplasty were suprapubic cystostomy only in 3 cases, and primary realignment or resection and end to end anastomosis in 8 cases. The 3 cases, who performed suprapubic cystostomy only had a long stricture in the posterior urethra, and the 8 cases were failed in primary realignment or resection & end to end anastomosis previously 6. The postoperative complications after skin inlay urethroplasty were meatal stenosis in 5 cases after primary stage, urethral stricture in 4 cases after secondary stage. The meatal stenosis was managed by urethral dilatation with metal sound, meatotomy and urethrotomy in 2 cases, and the remainder are undergoing of urethral dilatation at present due to recurrentmeatal stenosis. The urethral strictures in 4 cases after secondary stage were managed by urethral dilatation with metal sound, and urethrotomy in all cases satisfyingly. 7. Overall success rate were 73% (8 cases).