URETHROPLASTY IN POSTERIOR URETHRAL INJURIES
SABAH A. AI-Kadi & SAFAA A. Mohssin
Department of Urology, University of Baghdad, Iraq.
To assess the efficacy of urethroplasy (excision with end to end anastomosis) in posterior urethral injuries. Fifteen patients with complete urethra! disruption were treated by this method and followed with objectives and subjectives parameters for 2 years. The results are graded into 3 grades (excellent, satisfactory and poor) according to continence and flow rate of urine, 80% of cases have stricture (>2 cm) in length. Those patients who are treated with perineal approach result in (92%) excellent, in comparison to those with transpubic urethroplasty who give only (50%) excellent results. Patients with no history of urethral handling give (100%) excellent results, while only (25%) excellent results in patients with previous urethral surgical intervention.
Urethroplasty is the best method for repairing completely obliterated strictures. Intraoperative endoscopic checking of posterior urethra is important to avoid fistulous tracts. Dilatation and urethrotomy may be used as complementary procedures to urethroplasty. Pubectomy sometimes necessary in complicated cases.