ArticleWorld journal of urology2025
Posterior urethroplasty for pelvic fracture urethral injuries: risk factors for recurrence and complications.
Article in World journal of urology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.
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3 citing papers in PubMed.
- Long-term follow-up outcomes and independent predictors of surgical failure following posterior urethroplasty for pelvic fracture-associated urethral strictures.World journal of urology · 2026Article
- Magnetic resonance urethrography-derived geometric parameters and their association with surgical complexity in pelvic fracture urethral injury repair.International urology and nephrology · 2026Observational
- Interventional Radiology-Guided Foley Catheterization for Pelvic Fracture with Urethral Injury: A Single-Center Retrospective Case Series.Journal of clinical medicine · 2026Article
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4 authors.
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Abstract
purposeSurgical reconstruction for posterior urethral injuries associated with pelvic fractures (PFUI) is complex. Perineal posterior urethroplasty via excision and primary anastomosis (EPA) is the standard treatment. This study evaluates risk factors for stenosis recurrence after primary EPA and analyzes predictors of postoperative complications.
methodsA retrospective analysis was conducted on male patients who underwent primary posterior EPA for PFUI at Ghent University Hospital (2001-2024). The primary outcome was stenosis recurrence at 1-, 2-, and 10-year follow-up, defined as urethral narrowing causing obstructive symptoms and requiring intervention. Demographic data, prior urethral manipulation, surgical techniques, 90-day complications (Clavien-Dindo), and functional outcomes were analyzed. Univariate and multivariate coxregression analyses were performed using IBM SPSS Statistics v. 29.0.2.0.
resultsAmong 70 patients, 75.5% underwent transecting EPA. After a median follow-up of 130 months (IQR 78.5-178.5), stenosis recurrence occurred in 15.8% at a median of 3 months (IQR 2.0-5.0). The 1-, 2-, and 10-year recurrence-free survival rates were 85.4%, 83.8%, and 83.8%, respectively. In multivariate analysis, postoperative complications (HR = 4.85, p = 0.007) and persistent extravasation (HR = 6.36, p = 0.006) significantly increased recurrence risk. Postoperative complications (21.4%) were all low-grade and managed conservatively. Erectile function was impaired in 97.9% due to trauma, with 12.2% improving postoperatively. De novo urinary incontinence occurred in 6.6%.
conclusionsPosterior urethroplasty demonstrates a high long-term success rate in patients with PFUI. Postoperative complications and persistent urinary leakage significantly increase the risk of surgical failure, highlighting the need for rigorous follow-up. The non-transecting technique, when possible, does not negatively impact outcomes.
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