Primary Endoscopic Urethral Realignment by Rhinolaryngoscope
in Complete Posterior Urethral Injury

Keimyung Medical Journal 2010;29(2):163-167.

Primary Endoscopic Urethral Realignment by Rhinolaryngoscope in Complete Posterior Urethral Injury

완전후부요도손상에서 비후두경을 이용한 일차적 내시경하 요도재배열술

김병훈; 장혁수

Abstract

Primary realignment of complete urethral injury is a difficult procedure because of the pelvic bleeding and hematoma formation that occur during such injuries. In this study; we report the
results
of the treatment of complete posterior urethral injury by primary urethral realignment performed with the help of a rhinolaryngoscope. The primary urethral realignment was performed in the following sequence: (1) the proximal end of the obliterated urethra was directly observed with a flexible rhinolaryngoscope by using the antegrade approach; (2) a guidewire was passed through the flexible rhinolaryngoscope; (3) a 21 French (Fr) cystoscope with a 21 Fr urethrotome sheath was inserted through the distal urethra; (4) the obliteration of the urethra was confirmed using the guidewire; (5) the cystoscope was carefully inserted into the bladder; while the urethrotome sheath remained in the urethra; and (6) an 18 Fr Foley catheter was inserted into the bladder through the urethrotome sheath. This technique was investigated because it appears to be safe; simple; and minimally invasive. It is recommended for patients who have an unclear cystoscopic field due to pelvic bleeding or hematoma formation.

Key Words: Endoscopic surgical procedure, Injury, Laryngoscope, Urethra