Bladder neck reconstruction in girls’ pelvic fracture bladder neck avulsion and urethral rupture
| Autor: | Chongrui Jin, Yinglong Sa, Lin Wang, Rong Lv, Huiquan Shu |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2020 |
| Předmět: |
medicine.medical_specialty
Adolescent Urology Fistula Urinary Bladder 030232 urology & nephrology Urinary incontinence lcsh:RC870-923 Avulsion Fractures Bone 03 medical and health sciences 0302 clinical medicine Urethra Pediatric pelvic trauma medicine Humans Child Pelvic Bones Retrospective Studies Urinary continence business.industry Urethral rupture Infant Female pediatric urethral injury 030208 emergency & critical care medicine General Medicine medicine.disease lcsh:Diseases of the genitourinary system. Urology Surgery Bladder neck reconstruction Neck of urinary bladder medicine.anatomical_structure Reproductive Medicine Child Preschool Pelvic fracture Urologic Surgical Procedures Female medicine.symptom business Research Article |
| Zdroj: | BMC Urology, Vol 20, Iss 1, Pp 1-6 (2020) BMC Urology |
| ISSN: | 1471-2490 |
| DOI: | 10.1186/s12894-020-00741-z |
| Popis: | Background Girls’ pelvic fracture bladder neck avulsion and urethral rupture is rare however it causes great morbidity. The management is complex and not standard yet. We report our experience and a technique of bladder neck reconstruction with anterior bladder wall flap. Methods We retrospectively analysed data of 5 girls with pelvic fracture bladder neck avulsion and urethral rupture admitted to our institution from July 2017 to October 2019. They all came to our institution with a suprapubic tube. Patients’ trauma was all initially treated at other hospitals, 4 had suprapubic cystotomy and 1 had urethral realignment. One girl also had three other urethroplasties at other hospitals. We took pubectomy, posterior ureth roplasty and bladder neck reconstruction with anterior bladder wall flap in these 5 girls. Post-operative assessments included voiding cystourethrography, uroflowmetry and urethroscopy after urethral catheter removal. Verbal consent to participate was obtained from the parent or legal guardian of the children. Results Operation time ranged from 120 to 180 min. Follow-up time is 12 to 27 months. Uroflowmetry showed that maximum urine flow rate improved significantly. Cystourethrography indicated good continuity of the urethra. Two girls had urinary incontinence postoperatively but were continent 3 months later. One patient developed vesical-abdominal fistula and got repaired by surgery 6 months later. She was continent ever since. Other complications were not observed during the follow-up period. Conclusions Our method of bladder neck reconstruction using bladder flap as a patch is feasible and provides good continence, especially for those with serious bladder neck avulsion and urethral rupture caused by extensive trauma and those who had posttraumatic urethral distraction needed second repair. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
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