Penetrating Posterior Urethral Injuries: Case Report and Management Strategies

Penetrating posterior urethral trauma from gunshot wounds (GSW) is rare and requires prompt treatment to minimize complications. Data regarding the management of such cases is scarce in the literature and poorly addressed in the guidelines. Different management approaches exist, including urinary di...

Full description

Saved in:
Bibliographic Details
Main Authors: Seyed Sajjad Tabei, Brandon Lippold, Wesley Baas, Gregory Murphy
Format: Article
Language:English
Published: Wiley 2024-01-01
Series:Case Reports in Urology
Online Access:http://dx.doi.org/10.1155/2024/7839379
Tags: Add Tag
No Tags, Be the first to tag this record!
_version_ 1832559442916278272
author Seyed Sajjad Tabei
Brandon Lippold
Wesley Baas
Gregory Murphy
author_facet Seyed Sajjad Tabei
Brandon Lippold
Wesley Baas
Gregory Murphy
author_sort Seyed Sajjad Tabei
collection DOAJ
description Penetrating posterior urethral trauma from gunshot wounds (GSW) is rare and requires prompt treatment to minimize complications. Data regarding the management of such cases is scarce in the literature and poorly addressed in the guidelines. Different management approaches exist, including urinary diversion with immediate versus delayed urethroplasty/fistula repair. We present our case series to add to our experience to the literature. Three patients aged 18–44 presented with ballistic posterior urethra injuries from GSW. Initial management involved urethral catheter placement, with one patient requiring operative placement of urethral and suprapubic catheters (SPTs). Complications included recurrent membranous stricture, urinary retention, rectourethral fistula, and erectile dysfunction (ED). Posterior urethral injuries from GSW are complex as they can be either isolated or affect adjacent organs. Bladder, ureteral, and urethral injuries must be ruled out. Unlike bladder neck injuries, immediate urethroplasty/fistula repair would be very challenging and not advised for standard prostatic or membranous injuries. Urethral catheter or suprapubic tube is recommended and can result in fistula closure and urethral patency. It is critical to maintain close follow-up with the patient due to the possibility of stricture recurrence. Urethroplasty in a delayed fashion can be very successful.
format Article
id doaj-art-bd0304df900a48c28c52f0d8c9023ff6
institution Kabale University
issn 2090-6978
language English
publishDate 2024-01-01
publisher Wiley
record_format Article
series Case Reports in Urology
spelling doaj-art-bd0304df900a48c28c52f0d8c9023ff62025-02-03T01:30:04ZengWileyCase Reports in Urology2090-69782024-01-01202410.1155/2024/7839379Penetrating Posterior Urethral Injuries: Case Report and Management StrategiesSeyed Sajjad Tabei0Brandon Lippold1Wesley Baas2Gregory Murphy3Division of UrologyDivision of Urologic SurgeryDivision of UrologyDivision of Urologic SurgeryPenetrating posterior urethral trauma from gunshot wounds (GSW) is rare and requires prompt treatment to minimize complications. Data regarding the management of such cases is scarce in the literature and poorly addressed in the guidelines. Different management approaches exist, including urinary diversion with immediate versus delayed urethroplasty/fistula repair. We present our case series to add to our experience to the literature. Three patients aged 18–44 presented with ballistic posterior urethra injuries from GSW. Initial management involved urethral catheter placement, with one patient requiring operative placement of urethral and suprapubic catheters (SPTs). Complications included recurrent membranous stricture, urinary retention, rectourethral fistula, and erectile dysfunction (ED). Posterior urethral injuries from GSW are complex as they can be either isolated or affect adjacent organs. Bladder, ureteral, and urethral injuries must be ruled out. Unlike bladder neck injuries, immediate urethroplasty/fistula repair would be very challenging and not advised for standard prostatic or membranous injuries. Urethral catheter or suprapubic tube is recommended and can result in fistula closure and urethral patency. It is critical to maintain close follow-up with the patient due to the possibility of stricture recurrence. Urethroplasty in a delayed fashion can be very successful.http://dx.doi.org/10.1155/2024/7839379
spellingShingle Seyed Sajjad Tabei
Brandon Lippold
Wesley Baas
Gregory Murphy
Penetrating Posterior Urethral Injuries: Case Report and Management Strategies
Case Reports in Urology
title Penetrating Posterior Urethral Injuries: Case Report and Management Strategies
title_full Penetrating Posterior Urethral Injuries: Case Report and Management Strategies
title_fullStr Penetrating Posterior Urethral Injuries: Case Report and Management Strategies
title_full_unstemmed Penetrating Posterior Urethral Injuries: Case Report and Management Strategies
title_short Penetrating Posterior Urethral Injuries: Case Report and Management Strategies
title_sort penetrating posterior urethral injuries case report and management strategies
url http://dx.doi.org/10.1155/2024/7839379
work_keys_str_mv AT seyedsajjadtabei penetratingposteriorurethralinjuriescasereportandmanagementstrategies
AT brandonlippold penetratingposteriorurethralinjuriescasereportandmanagementstrategies
AT wesleybaas penetratingposteriorurethralinjuriescasereportandmanagementstrategies
AT gregorymurphy penetratingposteriorurethralinjuriescasereportandmanagementstrategies