Incidence of urethral stricture in patients with urethral trauma: a 10-year experience in an Indonesian tertiary hospital
Abstract
BACKGROUND Urethral injuries are rarely life-threatening but can cause significant morbidity if left untreated. Until now, data on urethral trauma incidence are still limited in Indonesia. This study aimed to report the incidence of traumatic urethral stricture within 10 years of experience in treating urethral trauma.
METHODS This retrospective study used a total sampling method for all patients with urethral trauma who came to the emergency department and agreed to undergo radiological evaluation. Patient data were collected from January 2012 to December 2021. All patients were followed up for 3 months after trauma, and the incidence of urethral stricture was analyzed using the chi-square or Fisher's exact tests as an alternative.
RESULTS The overall incidence of urethral stricture was 48.4%. Of 122 patients, 82.0% had anterior urethral trauma. Grade III American Association for the Surgery of Trauma (43.4%) was the most common urethral trauma. The cause of urethral trauma was iatrogenic, pelvic fracture urethral injury (PFUI), straddle injury, and penile fracture, contributing in 64.8%, 18.0%, 16.4%, and 0.8% of the cases, respectively. Most patients (70.5%) underwent a cystostomy catheterization procedure as initial treatment. Straddle injury, PFUI, and a higher degree of urethral trauma were significantly associated with urethral stricture formation (p<0.05).
CONCLUSIONS Straddle injury, PFUI, and a higher degree of urethral trauma were significantly related to a higher incidence of urethral stricture. Most low-grade and anterior urethral traumas can resolve spontaneously.
Downloads
References
Doll JA, Nikolsky E, Stone GW, Mehran R, Lincoff AM, Caixeta A, et al. Outcomes of patients with coronary artery perforation complicating percutaneous coronary intervention and correlations with the type of adjunctive antithrombotic therapy: pooled analysis from REPLACE-2, ACUITY, and HORIZONS-AMI trials. J Interv Cardiol. 2009;22(5):453−9. https://doi.org/10.1111/j.1540-8183.2009.00494.x
Shimony A, Joseph L, Mottillo S, Eisenberg MJ. Coronary artery perforation during percutaneous coronary intervention: a systematic review and meta-analysis. Can J Cardiol. 2011;27(6):843−50. https://doi.org/10.1016/j.cjca.2011.04.014
Ellis SG, Ajluni S, Arnold AZ, Popma JJ, Bittl JA, Eigler NL, et al. Increased coronary perforation in the new device era. Incidence, classification, management, and outcome. Circulation. 1994;90(6):2725-30. https://doi.org/10.1161/01.CIR.90.6.2725
Ajluni SC, Glazier S, Blankenship L, O'Neill WW, Safian RD. Perforations after percutaneous coronary interventions: clinical, angiographic, and therapeutic observations. Cathet Cardiovasc Diagn. 1994;32(3):206−12. https://doi.org/10.1002/ccd.1810320303
Januszek R, Bryniarski L, Siudak Z, Malinowski KP, Bryniarski KL, Surdacki A, et al. Five-year report from the Polish national registry on percutaneous coronary interventions with a focus on coronary artery perforations within chronic total occlusions. Postepy Kardiol Interwencyjnej. 2020;16(4):399-409. https://doi.org/10.5114/aic.2020.101764
Doll JA, Hira RS, Kearney KE, Kandzari DE, Riley RF, Marso SP, et al. Management of percutaneous coronary intervention complications: algorithms from the 2018 and 2019 Seattle Percutaneous Coronary Intervention Complications Conference. Circ Cardiovasc Interv. 2020;13(6):e008962. https://doi.org/10.1161/CIRCINTERVENTIONS.120.008962
Hartono B, Widito S, Munawar M. Sealing of a dual feeding coronary artery perforation with homemade spring guidewire. Cardiovasc Interv Ther. 2015;30(4):347−50. https://doi.org/10.1007/s12928-014-0299-8
Dippel EJ, Kereiakes DJ, Tramuta DA, Broderick TM, Shimshak TM, Roth EM, et al. Coronary perforation during percutaneous coronary intervention in the era of abciximab platelet glycoprotein IIb/IIIa blockade: an algorithm for percutaneous management. Catheterization Cardiovasc Interv. 2001;52(3):279-86. https://doi.org/10.1002/ccd.1065
Patel VG, Brayton KM, Tamayo A, Mogabgab O, Michael TT, Lo N, et al. Angiographic success and procedural complications in patients undergoing percutaneous coronary chronic total occlusion interventions: a weighted meta-analysis of 18,061 patients from 65 studies. JACC Cardiovasc Interv. 2013;6(2):128−36. https://doi.org/10.1016/j.jcin.2012.10.011
Dixon SR, Webster MW, Ormiston JA, Wattie WJ, Hammett CJ. Gelfoam embolization of a distal coronary artery guidewire perforation. Catheter Cardiovasc Interv. 2000;49(2):214−7. https://doi.org/10.1002/(SICI)1522-726X(200002)49:2<214::AID-CCD23>3.0.CO;2-1
Qin Q, Chang S, Xu R, Fu M, Chen L, Ge L, et al. Short and long-term outcomes of coronary perforation managed by coil embolization: a single-center experience. Int J Cardiol. 2020;298:18−21. https://doi.org/10.1016/j.ijcard.2019.07.091
Lemmert ME, van Bommel RJ, Diletti R, Wilschut JM, de Jaegere PP, Zijlstra F, et al. Clinical characteristics and management of coronary artery perforations: a single-center 11-year experience and practical overview. J Am Heart Assoc. 2017;6(9):e007049. https://doi.org/10.1161/JAHA.117.007049
Hachinohe D, Kashima Y, Okada Y, Kanno D, Kobayashi K, Kaneko U, et al. Coil embolization for coronary artery perforation: a retrospective analysis of 110 patients. J Interv Cardiol. 2021;2021:9022326. https://doi.org/10.1155/2021/9022326
Irie T. New embolization microcoil consisting of firm and flexible segments: preliminary clinical experience. Cardiovasc Intervent Radiol. 2006;29(6):986−90. https://doi.org/10.1007/s00270-005-0364-x
Kilic ID, Fabris E, Serdoz R, Caiazzo G, Foin N, Abou-Sherif S, et al. Coronary covered stents. EuroIntervention. 2016;12(10):1288−95. https://doi.org/10.4244/EIJV12I10A210
Harnek J, James SK, Lagerqvist B. Very long-term outcome of coronary covered stents: a report from the SCAAR registry. EuroIntervention. 2019;14(16):1660−7. https://doi.org/10.4244/EIJ-D-18-00855
Schächinger V, Hamm CW, Münzel T, Haude M, Baldus S, Grube E, et al. A randomized trial of polytetrafluoroethylene-membrane-covered stents compared with conventional stents in aortocoronary saphenous vein grafts. J Am Coll Cardiol. 2003;42(8):1360−9. https://doi.org/10.1016/S0735-1097(03)01038-6
Pienvichit P, Waters J. Successful closure of coronary artery perforation using makeshift stent sandwich. Catheter Cardiovasc Interv. 2001;54(2):209−13. https://doi.org/10.1002/ccd.1269
Song X, Qin Q, Chang S, Xu R, Fu M, Lu H, et al. Clinical outcomes of self-made polyurethane-covered stent implantation for the treatment of coronary artery perforations. J Interv Cardiol. 2021;2021:6661763. https://doi.org/10.1155/2021/6661763
Copyright (c) 2024 Paksi Satyagraha, Muhammad Adi Satrio Lazuardi, Taufiq Nur Budaya
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
Authors who publish with Medical Journal of Indonesia agree to the following terms:
- Authors retain copyright and grant Medical Journal of Indonesia right of first publication with the work simultaneously licensed under a Creative Commons Attribution-NonCommercial License that allows others to remix, adapt, build upon the work non-commercially with an acknowledgment of the work’s authorship and initial publication in Medical Journal of Indonesia.
- Authors are permitted to copy and redistribute the journal's published version of the work non-commercially (e.g., post it to an institutional repository or publish it in a book), with an acknowledgment of its initial publication in Medical Journal of Indonesia.
