Radiological Re-evaluation of Failed Anastomotic Urethroplasty for Pelvic Fractures Urethral Distraction Defect Injuries; Experience in 41 Patients

Document Type : Original Article

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Assiut Urology and Nephrology Hospital, Assiut University, Assiut, Egypt.

Abstract

Objectives: to evaluate the benefits of 3D CTCUG in the evaluation of failed anastomotic urethroplasty for PFUDDI.
Methods: Between April 2016 and February 2019, 41 patients with prior failed urethroplasty for PFUDDI were included in this prospective study. Patients initially underwent RUG and MCU followed by 3D CTCUG. The data obtained was compared to the intraoperative finding. Sample size was calculated according to Epi-Info version 7.1 for statistical calculation.
Results: The mean age was 29.85 ± 10.41(range 17-52) years. There was a significant difference between the mean length measured by RUG and the intraoperative length (p 0.003). There was no statistical significance between 3D CTCUG and intraoperative length. Urethro-rectal fistula was found in 5 patients intraoperatively. It was detected in 4 (9.8%) patients by both 3D CTCUG and combined RUG and MCU. Five (12.2%) patients have a prostatic urethral stone with a detection rate of 100% by 3D CTCUG, which was not detected by KUB or combined RUG and MCU.
Conclusions: 3D CTCUG can accurately measure the PFUDDI length, aid in the detection of some associated pathological conditions as URF, stones and ectopic bone fragments. Moreover, it is performed in only one position without distortion and with generation of 3D images.

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