Evaluating functional outcomes of urethroplasty for complete post-traumatic rupture of the posterior urethra.

INTRODUCTION

Post-traumatic posterior urethral rupture is a severe injury that may significantly affect the urinary and sexual outcome in predominantly young patients. Delayed urethroplasty after suprapubic catheterization remains a preferred approach and part of the urologist's therapeutic arsenal. The objective of our study was to report the urinary and sexual outcomes after delayed urethroplasty for complete post-traumatic rupture of the posterior urethra.

PATIENTS AND

METHODS

This is a retrospective multicentric study including all patients who underwent urethroplasty between 2014 and 2024 for complete post-traumatic rupture of the posterior urethra. Preoperative, perioperative, and postoperative outcome data were collected. Complications for the surgical procedure were analyzed, as well as postoperative stenosis, urinary incontinence and erectile dysfunction.

RESULTS

Forty-two patients were identified. The mean age was 33±10 years. In these patients, the mean postoperative bladder catheterization time was 20±4 days. The median postoperative follow- up period of 42 [24-64] months. Satisfactory voiding was noted in 28 patients (67%). The median IPSS score at the date of last news was 6 [0-22]. Internal urethrotomy following surgery was performed in night patients (22%), while three patients (7%) were treated for stress urinary incontinence. Five patients (12%) required a secondary urethroplasty. The median IIEF-5 score at the date of last news was 16 [15-19].

CONCLUSION

We therefore consider urethroplasty as the treatment of choice for complete traumatic posterior urethral rupture. However, there is a high rate of severe erectile dysfunction after urethroplasty urethroplasty for complete post-traumatic rupture of the posterior urethra.