Investig Clin Urol.  2020 Jan;61(1):99-106. 10.4111/icu.2020.61.1.99.

Effects of pelvic bone fracture on recurrence-free rate after bulbomembranous anastomotic urethroplasty in men with posterior urethral injuries

• Choi DK
• Kim S
• Oh JJ

• KMID: 2466798
• DOI: http://doi.org/10.4111/icu.2020.61.1.99

Abstract

PURPOSE
To determine the impact of pelvic bone fracture on the recurrence of urethral stenosis after bulbomembranous anastomotic urethroplasty.
MATERIALS AND METHODS
A total of 197 patients with complete posterior urethral injuries underwent bulbomembranous anastomotic urethroplasty. These patients were divided into two groups according to the presence of pelvic bone fracture. Recurrence of urethral stenosis was defined as the need for any postoperative surgical intervention. The surgical outcomes and postoperative recurrence rate of urethral stenosis were compared between the two groups, and significant predictors for posterior urethral restenosis, including pelvic bone fracture, were analyzed via multivariate analysis.
RESULTS
Of the patients, 92 had pelvic bone fractures and the other 105 patients did not. The patients with pelvic bone fracture had increased involvement of the prostatic urethra compared to the group without pelvic bone fracture (3.8% vs. 17.4%, p=0.002). Recurrence of urethral stenosis was more common in the pelvic bone fracture group (42/92, 45.7%) than the group without pelvic fracture (27/105, 25.7%). In a Kaplan"”Meier analysis, the recurrence rate at 5 years was significantly lower in the pelvic bone fracture group (59.1% vs. 72.6%, p=0.003). A Cox proportional hazard analysis showed that the presence of pelvic bone injury was a significant predictor of posterior urethral re-stenosis.
CONCLUSIONS
Patients with posterior urethral injuries associated with pelvic bone fracture had a higher recurrence rate of urethral stenosis after bulbomembranous anastomotic urethroplasty than those without pelvic bone fracture.

Keyword

Urethra; Urethral stricture; Urologic surgical procedures

MeSH Terms

Humans
Male
Multivariate Analysis
Pelvic Bones*
Recurrence
Urethra
Urethral Stricture
Urologic Surgical Procedures

Figure

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  Fig. 1 Recurrence free rate of urethral stenosis following bulbomembranous anastomotic urethroplasty's in men who had posterior urethral injury with pelvic bone fracture and without.

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