Four cases of complete traumatic rupture of female urethra were reviewed. Herein the incidence, etiology and treatment modalities of complete rupture of female urethra are discussed to propose guidelines for the proper management of these unusual injuries. I recommend the following: Through the retropubic approach in children, a primary realignment with either surgery or an interlocking Foley catheterization should be performed as in the delayed retropubic urethroplasty when primary realignment was not accomplished. Transvaginal repair is considered choice approach for the urethro-vaginal laceration due to other than pelvic fracture in adults.
Adult ; Catheters, Indwelling ; Female ; Human ; Male ; Urethra/injuries* ; Urethra/surgery ; Urography

Adult ; Humans ; Kidney ; surgery ; Laparoscopy ; Male ; Needles ; Urethra ; injuries

Adolescent ; Adult ; Anal Canal ; injuries ; Humans ; Male ; Middle Aged ; Rectum ; injuries ; Urethra ; injuries ; Urinary Bladder ; injuries ; Wounds, Penetrating ; diagnosis ; therapy

Current opinions on diagnosis and management of lower genitourinary injury: in bladder, urethra and outside genital organ. Bladder trauma included bladder tear and bladder break (break in and outside of peritoneum). Retrograde urethrography with contrast media was a standard method in diagnosis of bladder break. Treatment: bladder sutured operation was absolute indicated for break in peritoneum; break outside of peritoneum could be treated by putting a large size urethra tube. In urethra injury: 37-93% cases of posterior urethral break and at least 75% cases of anterior urethral break experienced bleeding symptoms. Diagnosis method: retrograde urethrography with contrast media. Treatment: percutaneous cystostomy and urethral imaging test performed just before intervention. Outside genital organ’s trauma accounted for 1/3-2/3 of urogenital organ trauma. The injury was common in male, rarely in vulva of female. In cases of skin loss of penis or testicle, they were conservative treated. A partial or total urethra break needed to suture one-stage on catheter to make barrel and urine intubation
Urogenital System ; Urogenital System/injuries ; Wounds and Injuries ; Urinary Bladder ; Urethra ; Genitalia ; Diagnosis ; Therapeutics

We report here the short-term results of 3 cases of cloacal and bladder exstrophy that underwent complete primary exstrophy repair. One case was diagnosed as bladder exstrophy and the others were diagnosed as cloacal exstrophy. Complete primary exstrophy repair for all 3 cases was carried out within 24 hours after birth. There was no wound dehiscence within the follow-up period of 12 months. The complete primary exstrophy repair with positioning the bladder neck and urethra in the deep pelvic cavity achieves a satisfactory short-term result.
Bladder Exstrophy* ; Cloaca ; Follow-Up Studies ; Neck ; Parturition ; Reconstructive Surgical Procedures ; Urethra ; Urinary Bladder* ; Wounds and Injuries

OBJECTIVEPenile fracture, being defined as rupture of the tunica albuginea of the corpus cavernosum, is uncommon. Here, we analyze findings on our patients during a 10-year period and evaluate the role of retrograde urethrography.

METHODSFrom February 2002 to April 2012, 116 patients were admitted with penile fracture at Ghaem Medical Center. Patient history and physical examination were taken at their admittance to detect probable urethral injury. Before surgery, retrograde urethrography was performed in all patients. The size and site of the tunical rupture were recorded. Then the rupture of tunica albuginea was sutured with nonabsorbable (3-0 nylon) sutures and the ties were placed on the internal surface (continuous method). All patients were followed up for 12 months.

RESULTSPatients' mean age was (32.78 ± 10.61) years and ranged (16-62) years. The mechanism of trauma was sexual intercourse in 103 patients (89%) and masturbation in 13 patients (11%). The most common site of injury found after exploration was right (55%) and lateral (74%) of the corpus cavernosum. The size of the tunical rupture was from 0.5 to 3.0 cm (mean 1.88 ± 0.72). Three of the patients had Marphan's syndrome. Urethral injury was detected by retrograde urethrography in 4 patients (3%) who had macroscopic hematuria and urethrorrhagia. During 12 months follow-up, no complication was seen.

CONCLUSIONThere is no need to perform retrograde urethrography unless the patients have gross hematuria or urethrorrhagia. The key to success in treatment of penile fracture is to achieve a rapid diagnosis based on history and a physical examination, avoid unnecessary imaging tests and perform immediate surgery to reconstruct the site of injury.

Adolescent ; Adult ; Humans ; Male ; Middle Aged ; Penis ; injuries ; surgery ; Rupture ; Sutures ; Urethra ; diagnostic imaging ; Young Adult

The incidence of complications has greatly increased in proportion to the modernized and sophisticated urologic techniques. The following are the results of a clinical survey made for the operations and ensuing complications among the in-patients at the Department of Urology, Han Yang University Hospital during the period of May 1972-May 1978. 1. The operated cases were 840 out of 1160 hospitalized patients, giving a ration of 72.4%. 2. The methods of anesthesia were as follows ; General endotracheal anesthesia 648 (77. 1%), Spinal anesth. 72 (8.6%), Local anesth. 72 (8.6%), and Caudal anesth. 29(3.5%) 3. Total numbers of complications were 120 complications were noted among 42 cases of urethra operation. 27 cases of bladder operation. 15 cases of kidney operation, and so on. 4. Organ distribution of this complication were as follow ; kidney 15. ureter 12, bladder 27, prostate 4, urethra 42, and scrotum and its contents were 12. 5. The most commonly observed complication vas wound abscess which occurred in 25 cases (20.8%) out of the total number of 120 complications, eventhough each operation has its specific finding of complication.
Abscess ; Anesthesia ; Humans ; Incidence ; Kidney ; Prostate ; Scrotum ; Ureter ; Urethra ; Urinary Bladder ; Urology ; Wounds and Injuries

We describe an unusual complication of coital trauma in a 29-year-old man who presented with a 3-year history of hematospermia and post-coital gross hematuria. Using urethroscopy under a semi-tumescent penis, an isolated urethral injury with active bleeding was detected at the prostatic urethra. The patient was successfully treated with transurethral fulguration. We suggest that isolated posterior urethral injury is one of the causes of male coital trauma, which might be asymptomatic when the penis is flaccid but show symptomatic bleeding when the penis is erect.
Adult ; Coitus ; Ejaculation ; Female ; Hematuria ; Humans ; Male ; Urethra ; injuries ; Urethral Diseases ; etiology

In patients with spinal cord injury, detrusor sphincter dyssynergia is a common and troublesome problem that may evoke progressive deterioration of upper urinary tract and urinary tract infection including sepsis. Instead of external sphincterotomy, urethral wallstent may be the useful treatment for the patients with detrusor sphincter dyssynergia refractory to conventional treatment. In addition, this method has some advantages of less invassive, less morbid and simpler technique than other treatment methods. We report our preliminary results of the urethral wallstent(MemothermR) for the treatment of 2 patients with complicated detrusor sphincter dyssynergia.
Ataxia* ; Humans ; Sepsis ; Spinal Cord Injuries ; Urethra* ; Urinary Bladder, Neurogenic ; Urinary Tract ; Urinary Tract Infections

PURPOSE: Midurethral sling procedure has become one of the most commonly performed procedures for the treatment of female stress urinary incontinence(SUI). Although complication rate is very low, some patients are required further treatment to correct unwanted problems after surgery as it continues to be more widely used. We evaluated the mesh-related complications in those who required further procedures after midurethral sling procedures. MATERIALS AND METHODS: From January 2000 to December 2005, female patients who underwent additional surgery because of complications after midurethral sling procedures for stress urinary incontinence were evaluated in this study. RESULTS: In 675 patients, 298 received a tension-free vaginal tape(TVT) and 377 received a Monarc(transobturator route, TOT) as a sling material at 3 different hospitals. 34(5.0%) out of 675 patients required additional surgery to correct complications including obstructive voiding symptoms, mesh extrusion, failed or recurred SUI, wound pain and mesh in the bladder. Mean age of 34 patients was 54.7, and TVT was used in 21(7.0%) out of 298 patients, Monarc was used in 12(3.4%) out of 377 as midurethral sling materials. In 19 patients who showed obstructive voiding symptoms, all were cured by mesh cutting and in 8 patients who complained of immediate recurrence of SUI, 7 showed complete dryness by shortening the loosen mesh. Mesh extrusion with vaginal erosion were observed in 3 and all were cured by segmental resection of mesh without recurrence of SUI. 2 patients who showed recurrence of SUI after 2 years of TVT received Monarc procedure. Mesh in the bladder which was found after 6 months of TVT was managed by endoscopic resection of mesh with Monarc procedure in 1, and suprapubic pain after TVT was improved by resection of TVT segment through suprapubic incision in 1. All reoperation procedures were performed by local anesthesia except 1(mesh in the bladder). CONCLUSION: These data demonstrate that midurethral sling is an excellent surgical procedure with low complication rate, high success rate in reoperation. However, care must be taken to reduce reoperation rate in applying tension of mesh on urethra because most patients(27 out of 34) who required reoperation have complained of obstructive voiding symptoms(19) and persistent incontinence(8).
Anesthesia, Local ; Female* ; Humans ; Recurrence ; Reoperation* ; Suburethral Slings* ; Urethra ; Urinary Bladder ; Urinary Incontinence* ; Wounds and Injuries