الفهرس | Only 14 pages are availabe for public view |
Abstract To investigate the mechanism of injury, wounds’ pattern and surgical management and outcomes of urethral and penile injures caused by firearm and explosion during the present war in Yemen. Methods: This prospective descriptive study was conducted in the Department of Urology at Kars El Ainy hospitals. We included 46 Yemeni military victims who sustained penile and/or urethral injuries during the existing Yemeni war. These patients received primary surgical care in Yemen and referred for further definitive treatment in Egypt from October 2018 to October 2020. Besides patients’ demographics, the cause of injury, site and severityof injuries and associated injuries were addressed together with the management, postoperative complications, and outcomes for these injuries. Results: 46 males with war-related penile and urethral injuries were enrolled in the study. The median age of the included subjects was 28 years and ranged from 18-50 years. More than half of participants [27 (58.7%)] endured posterior urethral injuries; 11 (23.9%) and 5 (10.9%) of whom had PUDD and associated urethra-rectal fistula, respectively. The remaining posterior urethral injuries were distributed as membranous 5 (10.9%), Membrano-prostatic 4 (8.6%) and bulbomembranous 2 (4.3%). 10 (21.7%) patients sustained anterior urethral injuries. Five of whom (10.9%) had bulbar urethral injuries and 5 (10.9%) had combined penile tissue and anterior urethral injuries. Isolated penile injuries represent 9 (19.6%), 4 of them had corpus cavernosum, glans injuries 3, complete avulsion 2. Injuries to the penis and anterior urethra were inflicted by Improvised Explosive Devices(IEDs) in 90% and 67%, respectively, while injuries to the posterior urethra were inflicted by firearms in 85%. During the 6-12-month follow-up period, only 4 cases (8.7%) demonstrated recurrent strictures which were doomed to be a failed procedure and were thus re-operated. Two additional patients (4.3%) developed ring strictures that was also repaired in a second intervention. Conclusion: Our study highlights the need for flexibility in managing urethral and penile GSW/explosions trauma. Further, the success rate of operating these injuries require highly experienced surgeons to enhance the outcome and minimize complications. |