Investig Clin Urol.  2022 Jan;63(1):118-122. 10.4111/icu.20210189.

A novel stricture prevention technique in blunt urethral injury: A multi-center retrospective observational study

Affiliations
  • 1Department of Urology, Shanxi Bethune Hospital, Shanxi Academy of Medical Sciences, Taiyuan, Shanxi, China
  • 2Department of Anesthesiology, Shanxi Bethune Hospital, Shanxi Academy of Medical Sciences, Taiyuan, Shanxi, China
  • 3Department of Urology, First Hospital of Shanxi Medical University, Taiyuan, Shanxi, China

Abstract

Purpose
Bulbar injury is the most common type of urethral injury. This study investigated the efficacy and safety of a novel technique, local urethral flushing, in preventing stricture formation after blunt bulbar urethra injuries.
Materials and Methods
This retrospective study included 205 males diagnosed with straddle injury-induced bulbar urethra injury at the Shanxi Bethune Hospital and First Hospital of Shanxi Medical University between January 2015 and January 2019. Patients were diagnosed by retrograde urethrography and classified as partial or complete urethral rupture according to the urethral integrity after injury. Complete urethral rupture patients received suprapubic cystostomy and received urethroplasty 3 months later. Patients with partial urethral rupture underwent endoscopic urethral realignment by cystoscopic guide-wire guided catheterization. Patients with both injury types were divided into 3 groups. The treatment groups received urethral flushing with 0.05% dexamethasone through a secondary ureteral catheter that locked at the urethral lesion. The blank control groups received normal saline. The negative control groups had only a single ureteral catheter placed. Patients were assessed for pain during catheterization, infection, and stenosis, and followed for at least 2 years.
Results
Stenosis rates and length were significantly reduced in the normal saline groups, and even further reduced in the dexamethasone groups. The negative control groups had significantly higher infection rates than patients in the dexamethasone or saline groups.
Conclusions
Local urethral flushing with dexamethasone could significantly decrease urethral stenosis rates and severity without increasing patients’ discomfort or infection risk.

Keyword

Blunt injury; Bulbar urethra; Dexamethasone; Local urethral flushing
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