We know that fixing the injuries immediately after they occur increases the chance of recurrent scarring and also can harm erections. Most of these traumatic injuries to the urethra can be fixed about three to six months after they occur. A catheter can be placed across the gap in hopes that the urethra will heal together or a catheter can be placed through the abdomen into the bladder (suprapubic tube) and a surgery can be done some time later to fix the scarring that develops. The initial management of these injuries involves a similar strategy to pelvic fracture injuries. Usually patients have a lot of bleeding from the penis and a large bruise forms in the groin and perineum (the area between the anus and the scrotum). In this injury, the urethra is squeezed against the underside of the pubic bone and forcefully divided in two. Some examples of this are falling upon the crossbar of a bicycle, a railing, or being bucked onto the horn of a saddle. Straddle injury - In this injury a male patient falls forcefully with the legs apart on something hard. This surgery is called a posterior urethroplasty. Scarring occurs in the area where the urethra was ripped apart and usually a surgery needs to be done where this scar is removed and the healthy urethra is brought to the tip of the prostate and sewn to the other uninjured portion of the urethra. Other times the damage is too severe and a catheter is left in the bladder and a plan is made for subsequent surgery in the future. Often a procedure is done to try to realign the urethra so that it can heal together over a catheter. This is called a posterior urethral disruption. Pelvic fracture - The sheering forces of the pelvic fracture tear the urethra into two somewhere around the location of the prostate as the urethra travels towards the bladder.The urethra is usually injured in one of two ways: Some genito-urinary injuries are managed with immediate surgery to save the life of the patients that have been the victims of trauma other injuries are managed with observation and delayed surgery if needed in the future after healing has had time to occur. The external genitalia and the urethra (urinary channel from the bladder) can also be damaged with site-specific trauma that can be fairly minor. These organs can be damaged along with other internal organs when patients have suffer massive multi-systems trauma from incidents like auto accidents, industrial accidents or when patients are victims of gunshot wounds or other violent crimes. The genito-urinary system encompasses many organs: If you have experienced a traumatic accident or injury that needs to be taken care of, contact our reconstructive urology clinic for an immediate consultation. Neither serious deformities nor erectile dysfunction occur as a consequence of a delay in surgery in the long term in patients with no urethral involvement within a given period of time.Traumatic injuries that affect the urinary tract and its organs or the male genitalia can be treated very effectively by our reconstructive urologists. Surgical repair has a good functional outcome and low complication rates in the long term. The results of the IIEF questionnaires of each group for time periods and for individual patients in each separate group were statistically similar. There was no statistically significant difference between the 3 groups in terms of age and length of tears. The mean number of hours from trauma to surgery was 11.3 ± 8.5. Overall, the mean follow-up was 46.1 ± 19.2 months. An erectile dysfunction score was calculated for every patient. We applied the validated Turkish version of the International Index of Erectile Function (IIEF) questionnaire 3 times: for the time period before the fracture, 1 year after the fracture, and at the time of the study. We evaluated 43 patients sorted into 3 groups according to the time interval until surgery. We investigated whether a delay in time until surgery, in terms of hours, has any effect on the overall long-term results of surgical repair of penile fractures.īetween 20, we operated on 56 patients with penile fractures.
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