요도손상에 대한 임상적 고찰 = A Clinical Survey of Urethral Injury

다국어 초록 (Multilingual Abstract)

In order to study method of management of urethral injury, the clinical survey was made on the 110 patients of urethral injury who were treated at the department of urology, Chungang Gil Genaral Hospital, during the period from Jan. 1990 to Jun. 1994.
In age distribution of 110 patients of urethral injury, age of 83 patients(75,5%) ranged from 20 to 49 years and the rate of male to female was 109:1. The most common cause of urethral injury was the fall down (66 patients;60%) and the most common clinical symptom was external urethral bleeding(81 patients;73.6%). The common associated injuries of the urethral injury were public bone fracture(24 patients), bone fracture of extrimites(10 patients), bowel perforation (6 patients). By the retrograde urethrogram, the most common site of injury was bulbous urethra(85 patients;77.3%) and the complete rupture was more frequent than imcomplete. In the 85 patients of anterior urethral injury, 48 cases were treated with suprapubic cystostomy immediately and 22 patients treated with suprapubic cystostomy, spontaneous voiding was possible in 8 patients during follow up, 32 patients treated with delayed endoscopic internal urethrotomy, urethral stricture occurred in 12 patients and 8 patients treated with end-to-end anastomosis, urethral stricture occurred in 3 patients. In the 25 patients of posterior urethral injury, 6 patients treated with delayed endoscopic internal urethrotomy, stricture occurred in 3 patients and 10 patients treated with delayed end-to-end anastomosis, stricture occurred in 3 patients.
In urethral injury, we think, the initial management which must be provided is catheterization without excessive force. If catheterization fails, the suprapubic cystostomy is the best alternative management, the definitive urethroplasty have to be followed 3 to 4 months later which remained urethral stricture.