Chung PH, et al. - As a part of this study, the researchers sought to illustrate the updated experience and potential benefits of early endoscopic realignment (EER), in the case of patients with pelvic fracture urethral injuries (PFUI). The overall success rate for EER was 9%. It did not hinder the subsequent urethroplasty success. The authors recommended against basing the decision for performing EER on success alone. Secondary benefits of EER were found and could lend a helping hand with the multidisciplinary care of a complex trauma patient. The management of PFUI was cumbersome and such patients ought to be referred to tertiary centers.

Methods

• This research encompassed a retrospective review of patients treated with EER following blunt PFUI.
• EER was carried out with a retrograde or a combined antegrade/retrograde approach via a cystoscope.
• Treatment success was defined as no secondary procedure or the ability to pass a cystoscope across the area of injury or surgical anastomosis.

Results

• The eligible candidates included thirty-two patients (mean age 38 years, range 17-73) who underwent EER between 2004 and 2016, with a mean follow up of 26 months (range 1-102).
• The median time to realignment was reported to be 2 days (range 0-6).
• In 72% of the cases, this procedure was conducted concomitantly with another surgical service.
• Median operative time for EER was 38 minutes (range 8-100). 29 patients (91%) failed EER, as determined via an intent-to-treat analysis.
• A subsequentendoscopic procedure with 22% success was undertaken in nine patients.
• Excision and primary anastomotic urethroplasty was conducted for 24 patients as a primary or secondary treatment, displaying 96% success.