Pelvic fracture urethral injuries (PFUI) occur in up to 10% of pelvic fractures. It remains controversial whether initial urethral realignment after PFUI decreases rates of urethral obstruction and the need for subsequent urethral procedures. The retrospective record review should determine the utility of acute urethral realignment after PFUI.
A retrospective chart review to compare outcomes between urethral realignment (group 1) and suprapubic tube (SPT) placement (group 2). The comparison will be between two routinely practiced management approaches of urethral injury after pelvic fracture. Prior studies demonstrate urethral realignment is associated with a 15% to 50% reduction in urethral obstruction, however, it has also been associated with higher rates of incontinence and erectile dysfunction. Our hypothesis is that early realignment of traumatic urethral injuries after pelvic fracture lowers the incidence of complications like urethral strictures and subsequent need for surgeries.
Study Type
OBSERVATIONAL
Enrollment
200
University of Utah
Salt Lake City, Utah, United States
Urethral obstruction
Rates of urethral obstruction identified by urethrogram or cystoscopy
Time frame: Through study completion, an average of 1 year
Treatment rate for urethral obstruction
The rate of interventions for urethral obstruction after injury
Time frame: Through study completion, an average of 1 year
Urethroplasty complexity - gap length during urethroplasty
The gap between the 2 severed ends of the urethra
Time frame: Through study completion, an average of 1 year
Urethroplasty complexity - bulbar mobilization length during urethroplasty
The length of bulbar mobilization
Time frame: Through study completion, an average of 1 year
Urethroplasty complexity - corporal splitting during urethroplasty
The need to split the 2 corporal bodies
Time frame: Through study completion, an average of 1 year
Urethroplasty complexity - total obstruction of the urethra during urethroplasty
Finding the urethra was completely obstructed
Time frame: Through study completion, an average of 1 year
Urethroplasty complexity - urethral diverticulum discovered during urethroplasty
Finding a urethral diverticulum
Time frame: Through study completion, an average of 1 year
Urethroplasty complexity - urethral fistula present
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Finding a urethral fistula
Time frame: Through study completion, an average of 1 year
Urethroplasty complexity - inferior pubectomy during urethroplasty
The need to remove the inferior portion of the symphysis pubis
Time frame: Through study completion, an average of 1 year
Urethroplasty complexity - total pubectomy during urethroplasty
The need to remove the complete symphysis pubis
Time frame: Through study completion, an average of 1 year
Erectile function- SHIM score
Erectile function measured by the Sexual Health Inventory for Men (SHIM)
Time frame: Through study completion, an average of 1 year
Erectile function - medical treatment rates
Measured by the need for pharmacologic treatment of erectile dysfunction
Time frame: Through study completion, an average of 1 year
Erectile function - surgical treatment rates
Rates of surgical treatment of erectile dysfunction
Time frame: Through study completion, an average of 1 year
Incontinence
Rates of surgical treatment of incontinence
Time frame: Through study completion, an average of 1 year
Post-injury complications
Calvien-Dindo grading
Time frame: 3 month period post acute urethral injury