Early Urethral Anastomosis of Traumatic Posterior Urethral Injuries: A Single Centre Experience

Purpose: To evaluate the effect of early urethral anastomosis (EUA) for traumatic posterior urethral injuries (TPUI) patients. Materials and methods: We retrospectively studied 73 patients in our hospital with traumatic posterior urethral injuries who underwent early urethral anastomosis or delayed urethroplasty (DU) between June 2011 and June 2015. Intraoperative and postoperative data on 26 patients who treated with EUA were compared to those on 47 patients underwent DU with one-year follow-up. Results: The time between the injury and the operation was an average of 7.9 days and 155.7 days in EUA and DU respectively. There was significant difference between the two groups in operation time which 93.5 ± 12.6 min and 110.2 ± 13.2 min. No patient had repeat urethroplasty in EUA, while 5 (10.6%) with a re-urethroplasty in DU. Success rate after the first operation was 88.5% in EUA while 66.0% in DU (P<0.05), however, the results of final success rate after a one year follow-up showed that no statistical significance difference (100% and 95.7% respectively). Incontinence (11.5%) and erectile dysfunction (23.1%) in EUA were similar in DU (19.1% and 36.2%, respectively). Patients with EUA noted an average of 1.4 procedures compared with an average of 2.9 in DU (P<0.05). Conclusions: EUA is an alternative maneuver for traumatic posterior urethral injuries, when the patient’s conditions were stable and severe complications were treated appropriately. It could decrease the operative time, incidence of re-stricture, average number of procedures, medical costs and the difficult of therapy.