Preliminary Experience of Nontransecting Urethroplasty for Pelvic Fracture-related Urethral Injury

OBJECTIVE To evaluate the urinary outcomes and preservation of erectile function in patients with pelvic fracture-related urethral injury (PFUI) after nontransecting spongiosum anastomotic urethroplasty (NTSAU). MATERIALS AND METHODS Fifty-nine male patients with PFUI following traumatic pelvic fracture underwent NTSAU. Inclusion criteria were age 18-60 years, posterior urethral stenosis < 2.5 cm without previous urethroplasty, and intact erectile function. Exclusion criteria were history of open urethroplasty, long-segment posterior urethral stenosis (> 2.5 cm), preoperative impotency, or age over 60 years. Pre-and postoperative outcome analyses were performed with a paired t test and chi-square test. RESULTS Between January 2011 and August 2015, 59 patients with a mean age of 38.5 years (range, 2159 years) and a mean stricture length of 2.0 cm (range, 1-2.5 cm) underwent simple NTSAU (group 1, n = 41) or NTSAU with inferior pubectomy (group 2, n = 18). Patients were followed for a mean 25 months (range, 12-60 months). The primary success rate was 96.6% (57 of 59), and stricture recurrence occurred in 2 (3.4%) patients. The secondary outcomes revealed no significant changes in number of events, tip rigidity, or duration of best episode between pre-and postoperative nocturnal penile tumescence test (on RigiScan) in group 1, but a slight decrease in group 2 (P <. 05). The limitation was the small sample size and heterogeneous population. CONCLUSION NTSAU is a safe, feasible, minimally invasive procedure for PFUI, optimizing erectile preservation. (C) 2017 Elsevier Inc.