Membranous urethral length on magnetic resonance imaging as a novel predictor of urinary continence after delayed anastomotic urethroplasty for pelvic fracture urethral injury.
Adult
Anastomosis, Surgical
Fractures, Bone
/ complications
Humans
Magnetic Resonance Imaging
Male
Middle Aged
Organ Size
Pelvic Bones
/ injuries
Postoperative Complications
/ epidemiology
Predictive Value of Tests
Retrospective Studies
Time-to-Treatment
Urethra
/ anatomy & histology
Urinary Incontinence
/ epidemiology
Urologic Surgical Procedures, Male
/ methods
Continence
Imaging
Pelvic trauma
Posterior urethral injury
Prediction
Urethral reconstruction
Journal
World journal of urology
ISSN: 1433-8726
Titre abrégé: World J Urol
Pays: Germany
ID NLM: 8307716
Informations de publication
Date de publication:
Jan 2022
Jan 2022
Historique:
received:
20
07
2021
accepted:
11
09
2021
pubmed:
22
9
2021
medline:
19
2
2022
entrez:
21
9
2021
Statut:
ppublish
Résumé
We studied the impact of membranous urethral length (MUL) on magnetic resonance imaging (MRI) on post-urethroplasty continence in male patients with pelvic fracture urethral injury (PFUI). Of 169 male patients with PFUI who underwent delayed anastomotic urethroplasty between 2008 and 2020, 85 who underwent preoperative MRI, had no recurrent stenosis on cystoscopy, and underwent a 1-h pad test 1 year after surgery were included. MUL was defined as the distance from the distal end of the disrupted proximal urethra to the apex of the prostate, as measured using T2-weighted MRI. Urinary incontinence (UI) was defined as a 1-h pad test weight > 2.0 g. None of the patients had UI before a pelvic fracture. Eighty-two patients (96.5%) had a measurable MUL, and the median length was 8.1 (interquartile range [IQR], 5.2-10.8) mm. The median weight of the 1-h pad test was 1.0 (IQR, 0.0-4.0) g, and 26 (30.6%) patients had UI. An open bladder neck (odds ratio [OR], 4.6; 95% confidence interval [CI], 1.0-22.0; p = 0.04) and a short measurable membranous urethra (for every extra mm: OR, 1.2; 95% CI, 1.0-1.3; p = 0.04) were significant UI predictors on multivariate analysis. A long MUL is significantly positively associated with urinary continence in male patients with PFUI. This could be of potential value to reconstructive urologists when counseling patients regarding post-urethroplasty continence before urethroplasty.
Identifiants
pubmed: 34545458
doi: 10.1007/s00345-021-03840-0
pii: 10.1007/s00345-021-03840-0
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
147-153Informations de copyright
© 2021. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.
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