Journal article
Management of Delayed Onset Postoperative Hemorrhage after Anastomotic Urethroplasty
Case reports in urology, Vol.2015, pp.646784-4
2015
DOI: 10.1155/2015/646784
PMCID: PMC4655270
PMID: 26635991
Abstract
Excision with primary anastomosis (EPA) urethroplasty is generally the preferred method for short strictures in the bulbar urethra, given its high success rate and low complication rate compared to other surgical interventions. Bleeding is a presumed risk factor for any surgical procedure but perioperative hemorrhage after an EPA requiring hospitalization and/or reintervention is unreported with no known consensus on the best course for management. Through our experience with three separate cases of significant postoperative urethral hemorrhage after EPA, we developed an algorithm for treatment beginning with conservative management and progressing through endoscopic and open techniques, as well as consideration of embolization by interventional radiology. All the three of these cases were managed successfully though they did require multiple interventions. We theorize that younger patients with more robust corpus spongiosum and more vigorous spontaneous erections, patients that have undergone fewer prior urethral procedures and therefore have more prominent vasculature, and those patients managed with a two-layer closure of the ventral urethra without ligation of the transected bulbar arteries are at a higher risk for this complication.
Details
- Title: Subtitle
- Management of Delayed Onset Postoperative Hemorrhage after Anastomotic Urethroplasty
- Creators
- L. A Bertrand - Department of Urology, University of Iowa Hospitals and Clinics, 200 Hawkins Drive, 3RCP, Iowa City, IA 52242, USAS. P Elliott - Department of Urology, University of Minnesota, 420 Delaware Street, SE b435, Minneapolis, MN 55455, USAB. N Breyer - Department of Urology, University of California San Francisco, 1001 Potrero Avenue, SFGH 3, San Francisco, CA 94110, USAB. A Erickson - Department of Urology, University of Iowa Hospitals and Clinics, 200 Hawkins Drive, 3RCP, Iowa City, IA 52242, USA
- Resource Type
- Journal article
- Publication Details
- Case reports in urology, Vol.2015, pp.646784-4
- DOI
- 10.1155/2015/646784
- PMID
- 26635991
- PMCID
- PMC4655270
- NLM abbreviation
- Case Rep Urol
- ISSN
- 2090-696X
- eISSN
- 2090-6978
- Publisher
- Hindawi Publishing Corporation
- Language
- English
- Date published
- 2015
- Academic Unit
- Urology
- Record Identifier
- 9984051583602771
Metrics
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