A new technique for immediate endoscopic realignment of post-traumatic bulbar XXXX .

@entity1 @entity397 @entity3832 @entity130
OBJECTIVES: @entity130 with partial or complete disruption of urethral integrity can lead to voiding problems and serious infections. We report a new management technique involving immediate endoscopic realignment with drainage via peel-away sheath for post-traumatic bulbar @entity397 . METHODS: Thirteen @entity1 presenting with post-traumatic bulbar @entity397 between July 2010 and May 2013 were treated. An 18F peel-away sheath was inserted into the anterior urethra, then a ureteroscope or nephroscope was inserted into the peel-away sheath with continuous normal saline infusion and drainage through the cavity between ureteroscope and sheath to maintain operative field clarity. A guide wire was negotiated across the disruption to the bladder and an 18F Foley catheter inserted for 2-4 weeks. @entity397 severity was evaluated by urethroscopy during operation. Two @entity1 had partial @entity397 and 11 complete rupture. Before Foley catheter removal, pericatheter urethrography was performed to determine if urinary extravasation had occurred. Urethroscopy was performed after catheter removal. Follow-up uroflowmetry was conducted monthly for 1 year. RESULTS: This technique was successful in all @entity1 and none experienced urinary extravasation or required open surgery. Mean operation time was 4.9  1.6 min (3-8 min) and the mean Foley catheter indwelling time was 25.8  5.3 days. During follow-up (18.4  5.4 months, 12-26 months), 6 @entity1 developed @entity3832 (8.7  10.5 weeks, 1-28 weeks post-treatment). Strictures were managed by internal urethrotomy (1 @entity1 ) or urethral sound dilation (5) without open urethroplasty. CONCLUSIONS: Immediate endoscopic realignment with drainage via peel-away sheath is a fast, effective, and safe technique for bulbar @entity397 .
