Mp64-19 Retrospective Review of Penetrating Urethral Trauma at Single Institution Level 1 Trauma Center

You have accessJournal of UrologyReconstruction: External Genitalia and Urotrauma (Including Transgender Surgery and Traumatic Fistula) II (MP64)1 May 2024MP64-19 RETROSPECTIVE REVIEW OF PENETRATING URETHRAL TRAUMA AT SINGLE INSTITUTION LEVEL 1 TRAUMA CENTER Adrianna J. Lee, Anjali Shekar, and Sarah Faris Adrianna J. LeeAdrianna J. Lee , Anjali ShekarAnjali Shekar , and Sarah FarisSarah Faris View All Author Informationhttps://doi.org/10.1097/01.JU.0001008824.92877.7f.19AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Traumatic injury to the urethra is uncommon and injury pattern and management options are heterogenous. The AUA Urotrauma guidelines are made up of all Grade C or Expert Opinion recommendations. We examined characteristics and outcomes of urethral injuries over a 5 year period at a single institution level 1 trauma center. METHODS: Records of all male patients who underwent retrograde urethrogram between 2018-2023 were reviewed to identify those who experienced a traumatic urethral injury. Mechanism of injury, location of injury in the urethra, initial diagnostic method, initial treatment, and follow up information was extracted. RESULTS: Twenty five cases were compiled over 5 years. Average age at time of injury was 34 years old (18-66 years old). Injuries were stratified into gunshot wounds (GSWs) (68%, 17/25), motor vehicle accidents (MVAs) (28%, 7/25), stab wounds (4%, 1/25). Injuries were diagnosed with cystoscopy (40%, 10/25), retrograde urethrogram (32%, 8/25), cystogram (20%, 5/25), or surgical exploration (8%, 2/25). Posterior urethral injuries were most associated with MVAs (86%, 6/7) and concurrent pelvic fractures (57%, 4/7). All patients were treated with urethral catheter placement. One patient required re-intervention with dilation. Bulbar urethral injuries were most associated with GSWs (88%, 8/9) and concurrent scrotal injuries (33%, 3/9). These injuries were primarily treated with urinary diversion (urethral catheter 67%, 6/9; SPT 33%, 3/9) and had the highest rate of re-intervention (33%, 3/9), with 2 patients requiring urethroplasty and 1 patient requiring embolization. Penile urethral injuries were most associated with GSWs (87%, 7/8). All patients who underwent primary urethral repair (16%, 4/25) had penile urethral injuries and none required re-intervention with urethroplasty, regardless of whether initial repair was performed by a fellowship trained reconstructive urologist. CONCLUSIONS: GSW was the mechanism of injury with the most variable presentation and management strategies, and was typically associated with anterior urethral injuries. Penile urethral injuries could usually be successfully repaired primarily at the time of the injury, whereas bulbar urethral injuries could be managed conservatively with urethral catheterization and later repair if needed. Source of Funding: None © 2024 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 211Issue 5SMay 2024Page: e1048 Advertisement Copyright & Permissions© 2024 by American Urological Association Education and Research, Inc.Metrics Author Information Adrianna J. Lee More articles by this author Anjali Shekar More articles by this author Sarah Faris More articles by this author Expand All Advertisement PDF downloadLoading ...