Between Aug. 1985 and Dec. 1995, among 18 patients with trauma of anterior urethra 7 were treated by an endoscopically guided primary urethral realignment under intravenous injection of analgesics. Of the 5 partial ruptures, 3 had excellent results without stricture from 2 months to 4 years (mean 13 months) and resulted in 23-37ml/sec maximal uroflow rate. Then 2 had focal urethral stricture, which could be easily treated with endoscopic internal urethrotomy. Before endoscopically guided primary urethral realignment was done, 6 urethral ruptures without pelvic bone fracture partial rupture 3 cases, complete rupture 3 cases) were performed suprapubic cystostomy and urethroplasty stepwise. We experienced urethral stricture in 6 cases, then performed endoscopic internal urethrotomy and urethroplasty. 4 cases of urethral rupture with pelvic bone fracture partial rupture 1 case, complete rupture 3 cases) were performed suprapubic cystostomy and primary urethroplasty, then there were urethral stricture in all 4 cases. This method offers simpler and more effective than conventional methods without pelvic bone fracture under intravenous injection of analgesics.
Analgesics ; Constriction, Pathologic ; Cystostomy ; Endoscopy ; Humans ; Injections, Intravenous ; Pelvic Bones ; Rupture* ; Urethra ; Urethral Stricture

Seven patients with bladder stones underwent percutaneous ultrasonic lithotripsy, suprapubically The stones ranged from 1.7 to 4.0 cm (mean 2.3 cm) in diameter. Mean treatment time was 49 minutes with a range of 10 to 120 minutes. The stone free rate was 100%. Among 7 patients 3 had unclear causes for bladder stone formation but 4 associated with etiologic disorders; BPH in 1, neurogenic bladder after spinal injury in 1, anterior urethral stricture in 1 and foreign body (paraffin) in bladder in 1. Under the intravenous narcotics and local anesthesia, all 7 patients well tolerated to pain but 6 complained a minimal voiding sense during the procedure. There was no complication such as bladder injury, bleeding or severe hematuria. Therefore, percutaneous suprapubic ultrasonic lithotripsy is considered to be a simple, safe and efficient outpatient procedure for the treatment of bladder stone.
Anesthesia, Local ; Foreign Bodies ; Hematuria ; Hemorrhage ; Humans ; Lithotripsy* ; Narcotics ; Outpatients ; Spinal Injuries ; Ultrasonics* ; Urethral Stricture ; Urinary Bladder Calculi* ; Urinary Bladder* ; Urinary Bladder, Neurogenic