Recently we experienced 10 cases of posterior urethral injury associated with pelvic fracture. Of these patients 5 underwent primary realignment with perineal traction on the prostate (Selikowitz method), and the other 5 underwent immediate cystostomy and delayed urethroplasty (Johanson method). Comparison of the post-operative complications didn`t appear to show significant differences in the 2 groups, although the numbers were small. But patients who performed immediate cystostomy and delayed urethroplasty showed some disadvantages of the long period of treatment, high charges, often multiple hard procedures and the long time of operation. Therefore in the initial management of posterior urethral injury, we think it better to take primary realignment in Korean socioeconomic circumstances, if the patient is not in the high risk.
Cystostomy ; Humans ; Prostate ; Traction

Nguyen Thanh Nhu has made a modified trocar: The Saigon trocar (patent pending) easy to be made in Vietnam, easy to use, safe, easy to maintenance and sterilisation, used with a 18F Foley catheter. We have performed cystostomies by using the Saigon trocar to put Foley catheters of 18F for 70 patients and by open surgery to put Foley catheters of 22F for 40 patients at Binh Dan hospital and 115 People Hospital in 1999. No operative complication has been recorded for trocar cystostomy: however, 7 failed cases because the procedure has not been carried out properly, had to be switched to open surgery. Using the Saigon trocar to perform suprapublic cystostomy reduces significantly procedure time and post-operative days, therefore the treatment cost is reduced (roughly 500000 VND/case). To prevent from complications, the procedure must be right indicated and done with good care (bladder volume >330ml, puncture perpendicularly to the abdominal wall).
Cystostomy ; Surgical Instruments ; surgery

Urethroplasty was done in 6 patients with posterior urethral disruption with pubectomy and end to end anastomosis or full thickness tube graft of the urethra. The following results were obtained. 1. Transpubic approach provided excellent access to posterior urethra in every case. 2. Immediate cystostomy was done in all cases and reconstruction of the urethra later. 3. One of two tube graft and three of four end to end anastomosis were successful. 4. There were no orthopedic problem, incontinence or sexual impotency.
Cystostomy ; Humans ; Orthopedics ; Transplants ; Urethra

Metastatic urethral tumor is extremely rare. We report a case of anterior urethral and hepatic metastasis from a rectal adenocarcinoma developed 17 months after radical resection of rectal cancer. The patient was performed suprapubic cystostomy for management of voiding difficulty, thereafter, died 4 months after presentation.
Adenocarcinoma* ; Cystostomy ; Humans ; Neoplasm Metastasis* ; Rectal Neoplasms

The causes of urethrorectal fistula are multiple such as trauma, open prostatectomy, radiation therapy, infection and congenital anomaly and so forth. In considering the injured area, length and the condition or periurethral tissue, numerous approaches have been advocated for the treatment of the traumatic urethrorectal fistula. Herein we report the experience of successful transsacral repair of traumatic urethrorectal fistula in a 14 year-old male patient 3 months after cystostomy and colostomy installed.
Adolescent ; Colostomy ; Cystostomy ; Fistula* ; Humans ; Male ; Prostatectomy

A clinical observation was made on the anterior urethral injuries of the inpatients in the Department of Urology, Maryknoll HospitaI Juring the period from July 1, 1978 to December 3I. 1979. The following results were obtained. I. During the period the total number of patients with anterior urethral injury was 23 cases 2. Most favorable age was 20 to 40 years which was about 70%. 3. Fall from a height was the most common cause of anterior urethral injury. 4. Average duration of removal of suprapubic catheter was 18 days. 5. Average duration of first voiding after cystostomy was 8 days 6. Period of average admission was 25 days. 7. Partial urethral rupture showed better result than complete urethral rupture 8. Among 23 patients with anterior urethral injuries I8 cases were treated after cystostomy. with percutaneous cystostomy. Of these patients I3 cages recovered with good results.
Catheters ; Cystostomy* ; Humans ; Inpatients ; Rupture ; Urology

21 patients of urethral injury was made for diversion of urine by suprapubic cystostomy as initial treatment. In our experience suprapubic cystostomy at the time of injury followed 9-17 weeks later by perineal urethroplasty resulted in a low incidence of complication. The following results were obtained. 1. The most common cause of urethral injury was traffic accident. 2. The most common clinical symptom was external urethral bleeding. 3. Among the 13 cases of complete urethral injury, posterior urethral injury was in 11 cases. 4. Of 7 patients with fractured pelvis most had posteriorurethral injuries, except for 1 case of falling inwhich . the injury involved the anterior urethra. 5. Normal micturation was in 2 cases who were performed suprapubic cystostomy alone. 6. Duration from urethral injury from urethroplasty was 9-17 weeks. 7. Urethral stricture and incontinence after urethroplasty were in 1 case each.
Accidents, Traffic ; Cystostomy ; Hemorrhage ; Humans ; Incidence ; Pelvis ; Urethra ; Urethral Stricture

The technique of synchronous pressure-flow studies requires the use of either a transurethral or a suprapubic catheter. Although the flow is impaired by the presence of catheter, the use of transurethral catheter can eliminate unnecessary cystostomy procedure. We evaluated the effect of urethral catheter on the roflow. The maximal and average urinary flow rates of healthy volunteer of 24 male and 7 female were measured in the presence and absence of a 5Fr. and 8Fr. urethral catheter. A comparison of these flow rates showed that those measured with the catheter in situ were lower than those in the absence of a catheter. There was an insignificant decrease in maximal flow rate(MFR) from 20.8+/-6.3(ml/sec) to 20.4+/-4.9 and 19.0+/-5.2 with 5Fr. and 8Fr. urethral catheter, respectively The average flow rate(AFR) was also decreased insignificantly from 10.7+/-3.8(ml/sec) to 9.5+/-2.3 and 8.8+/-2.3 with 5Fr. and 8Fr. urethral catheter, respectively. The followings are correlation formulae of AFR and MFR according to diameter of urethral catheter in situ. MFR=0.79xMFR(5Fr.) + 4.71 (R square=0.37), MFR=0.74xMFR (8Fr.) + 6.92 (R square=0.32), AFR=1.00xAFR(5Fr.) + 1.48 (R square=0.35), AFR=1.23xAFR(8Fr.) - 0.15 (R square=0.59) (MFR : maximal flow rate, AFR : average flow rate).
Catheters ; Cystostomy ; Female ; Healthy Volunteers ; Humans ; Male ; Urinary Catheters*

Transurethral removal of bladder or urethral stones in children is not easy and open removal of the stone is required in many cases because the urethra in a child is narrow and adequate equipment is not available. In a 6-year old boy with multiple urinary stones who had underwent vesicolithotomy twice before, we tried percutaneous removal of the bladder stones using suprapubic trocar and adult cystourethroscope set. Nelaton catheter was used as a guide wire in Seldinger technique while switching the instruments through the suprapubic cystostomy tract. With the same technique we removed a urethral stone in a 5-year boy successfully."
Adult ; Catheters ; Child* ; Cystostomy ; Humans ; Male ; Surgical Instruments ; Urethra ; Urinary Bladder Calculi* ; Urinary Bladder* ; Urinary Calculi

The treatment of traumatic disruption of the urethra must be tailored to the anatomical situation. It is too hard to know true length and situation of urethral stricture by concomitant retrograde and voiding cystourethrography, due to the bladder neck failed to open usually, Sometimes urologist have performed cystoscope or sound through by suprapubic cystostomy on retrograde urethrography to confirm the length of the urethral stricture. But these methods are complicated and invasive. Alpha adrenoceptor has been known to do important role in the bladder neck and prostatic urethra. So alpha adrenoceptor blocker( terazosin) has been used to decrease tone of internal urethral sphincter of the patient with benign prostatic hypertrophy. Under that theory, we tried terazosin per oral route when we performed the concomitant retrograde and voiding cystourethroscopy in 3 patients with complete membranous urethral stricture and 3 patients with bulbomembranous and 2 patients with bulbar urethral stricture. Dosage of terazosin was 1 to 10mg. The length and site of the stricture were not visualized by usual method without terazosin. In that cases we performed concomitant retrograde and voiding cystourethrography 1 hour after intake of terazosin. Terazosin well visualized site of the urethral stricture in 7 patients who had intact internal urethral sphincter.
Constriction, Pathologic ; Cystoscopes ; Cystostomy ; Humans ; Neck ; Prostatic Hyperplasia ; Urethra ; Urethral Stricture* ; Urinary Bladder