Pelvic Fracture, Surgery, Trauma, Urethra Injury Male, Urethra Tear
Conditions
Keywords
pelvic fracture urethral injury, urethra, disruption, trauma
Brief summary
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.
Detailed description
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.
Interventions
None listed
Sponsors
University of Utah
Study design
Observational model
COHORT
Time perspective
RETROSPECTIVE
Eligibility
Sex/Gender
MALE
Age
18 Years to No maximum
Inclusion criteria
Men \> 18 years old Blunt force trauma Presence of pelvic fracture Urethral injury Inability to pass a Foley catheter retrograde through the injury into the bladder
Exclusion criteria
Straddle type urethral injuries without a pelvic fracture Passage of a catheter successfully in a retrograde fashion
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Urethral obstruction | Through study completion, an average of 1 year | Rates of urethral obstruction identified by urethrogram or cystoscopy |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Urethroplasty complexity - gap length during urethroplasty | Through study completion, an average of 1 year | The gap between the 2 severed ends of the urethra |
| Urethroplasty complexity - bulbar mobilization length during urethroplasty | Through study completion, an average of 1 year | The length of bulbar mobilization |
| Urethroplasty complexity - corporal splitting during urethroplasty | Through study completion, an average of 1 year | The need to split the 2 corporal bodies |
| Urethroplasty complexity - total obstruction of the urethra during urethroplasty | Through study completion, an average of 1 year | Finding the urethra was completely obstructed |
| Urethroplasty complexity - urethral diverticulum discovered during urethroplasty | Through study completion, an average of 1 year | Finding a urethral diverticulum |
| Urethroplasty complexity - urethral fistula present | Through study completion, an average of 1 year | Finding a urethral fistula |
| Treatment rate for urethral obstruction | Through study completion, an average of 1 year | The rate of interventions for urethral obstruction after injury |
| Urethroplasty complexity - total pubectomy during urethroplasty | Through study completion, an average of 1 year | The need to remove the complete symphysis pubis |
| Erectile function- SHIM score | Through study completion, an average of 1 year | Erectile function measured by the Sexual Health Inventory for Men (SHIM) |
| Erectile function - medical treatment rates | Through study completion, an average of 1 year | Measured by the need for pharmacologic treatment of erectile dysfunction |
| Erectile function - surgical treatment rates | Through study completion, an average of 1 year | Rates of surgical treatment of erectile dysfunction |
| Incontinence | Through study completion, an average of 1 year | Rates of surgical treatment of incontinence |
| Post-injury complications | 3 month period post acute urethral injury | Calvien-Dindo grading |
| Urethroplasty complexity - inferior pubectomy during urethroplasty | Through study completion, an average of 1 year | The need to remove the inferior portion of the symphysis pubis |
Countries
United States
Outcome results
None listed