PURPOSE: The aim of this study was to evaluate the long-term results of endoscopic primary realignment of a posterior urethral rupture accompanied by a pelvic bone fracture. MATERIALS AND METHODS: Our study population consists of 7 patients who were able to be followed up for at least 5 years, of an initial 8 that underwent endoscopic primary realignment of a posterior urethral rupture due to a pelvic bone fracture. Operations were carried out in the following order; the bladder was incised to allow a metal sound, with stitching fiber then tied at its end so it could be advanced into the injured proximal urethra through the bladder neck. The fiber was then traced using a cystoscope and connected to a urethral catheter, which could be indwelled in the bladder by pulling the sound back. RESULTS: The mean follow-up period was 8.1 (5.2-9.7) years. The mean operation time was 48.3 (28-71) minutes. There were no severe disruptions of the pelvic hematoma, transfusions or other additive injuries during the operations. Post-operation complications were observed in 4 patients; 3 cases of mild urethral stricture, which were treated with an endoscopic intra-urethrotomy followed by clean intermittent catheterization, 3 cases of erectile dysfunction and 1 case each of urinary incontinence and a urethral stone. CONCLUSIONS: This study clearly implies that endoscopic primary realignment of a severe posterior urethral rupture accompanied by a pelvic bone fracture is less invasive and a safer method, without pelvic hemorrhage or additional injuries. Early endoscopic intervention also improves the quality of life by reducing the possibility of an invasive procedure, and also prevents severe urethral stricture and the resultant complications by maintaining the continuity of the urethra.
Cystoscopes ; Cystostomy* ; Erectile Dysfunction ; Follow-Up Studies ; Hematoma ; Hemorrhage ; Humans ; Intermittent Urethral Catheterization ; Male ; Neck ; Pelvic Bones* ; Quality of Life ; Rupture* ; Urethra ; Urethral Stricture ; Urinary Bladder ; Urinary Catheters ; Urinary Incontinence

OBJECTIVES: The purpose of the present study was to investigate the effects of volatile organic compounds, and formaldehyde on heart rate variability among elderly people who are vulnerable to ambient pollution. METHODS: From May to August of 2009, 57 subjects older than 60 years were recruited in this study. Indoor air pollutants (volatile organic compounds and formaldehyde) were measured by a personal passive sampler. Heart rate variability (HRV) was measured in the sitting position for five minutes and assessed by time-domain and frequency-domain. RESULTS: Multiple linear regression analysis showed significantly less low-frequency (LF) and high-frequency (HF) associated with elevated benzene levels. Exposure to toluene was associated with decreases in the Standard deviation of the NN intervals (SDNN) and LF. SDNN and LF were negatively associated with the increment of ethylbenzene levels. CONCLUSIONS: An adverse effect on cardiovascular function caused by volatile organic compounds was observed among the elderly people of Seoul even though indoor air pollutant levels were lower than the yearly average guideline for indoor air quality in Korea.
Aged ; Air Pollutants ; Air Pollution, Indoor ; Benzene ; Benzene Derivatives ; Formaldehyde ; Heart ; Heart Rate ; Humans ; Korea ; Linear Models ; Toluene ; Volatile Organic Compounds