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2. A multicenter prospective cohort study of endoscopic urethral realignment versus suprapubic cystostomy after complete pelvic fracture urethral injury

Author

McCormick, Benjamin J, Keihani, Sorena, Hagedorn, Judith, Selph, J Patrick, Figler, Bradley D, Johnsen, Niels V, da Silva, Rodrigo Donalisio, Broghammer, Joshua A, Gupta, Shubham, Miller, Brandi, Burks, Frank N, Eswara, Jairam, Osterberg, E Charles, Carney, Kenneth J, Erickson, Bradley A, Gretzer, Matthew B, Chung, Paul H, Harris, Catherine R, Murphy, Gregory P, Rusilko, Paul, Shridharani, Anand, Benson, Cooper, Alwaal, Amjad, Blaschko, Sarah D, Breyer, Benjamin N, Amend, Gregory M, McKibben, Maxim, Elliott, Sean P, Schwartz, Ian W, Simhan, Jay, Vanni, Alex J, Moses, Rachel A, and Myers, Jeremy B

Subjects
Biomedical and Clinical Sciences, Clinical Sciences, Clinical Research, Physical Injury - Accidents and Adverse Effects, Urologic Diseases, Humans, Adult, Prospective Studies, Cystostomy, Urethra, Urethral Diseases, Fractures, Bone, Pelvic Bones, Urethral Obstruction, Urethral injury, pelvic fracture, suprapubic tube, urethral realignment, Clinical sciences, Nursing
Abstract

BackgroundPelvic fracture urethral injury (PFUI) occurs in up to 10% of pelvic fractures. There is mixed evidence supporting early endoscopic urethral realignment (EUR) over suprapubic tube (SPT) placement and delayed urethroplasty. Some studies show decreased urethral obstruction with EUR, while others show few differences. We hypothesized that EUR would reduce the rate of urethral obstruction after PFUI.MethodsTwenty-six US medical centers contributed patients following either an EUR or SPT protocol from 2015 to 2020. If retrograde cystoscopic catheter placement failed, patients were included and underwent either EUR or SPT placement based on their institution's assigned treatment arm. Endoscopic urethral realignment involved simultaneous antegrade/retrograde cystoscopy to place a catheter across the urethral injury. The primary endpoint was development of urethral obstruction. Fisher's exact test was used to analyze the relationship between PFUI management and development of urethral obstruction.ResultsThere were 106 patients with PFUI; 69 (65%) had complete urethral disruption and failure of catheter placement with retrograde cystoscopy. Of the 69 patients, there were 37 (54%) and 32 (46%) in the EUR and SPT arms, respectively. Mean age was 37.0 years (SD, 16.3 years) years, and mean follow-up was 463 days (SD, 280 days) from injury. In the EUR arm, 36 patients (97%) developed urethral obstruction compared with 30 patients (94%) in the SPT arm ( p = 0.471). Urethroplasty was performed in 31 (87%) and 29 patients (91%) in the EUR and SPT arms, respectively ( p = 0.784).ConclusionIn this prospective multi-institutional study of PFUI, EUR was not associated with a lower rate of urethral obstruction or need for urethroplasty when compared with SPT placement. Given the potential risk of EUR worsening injuries, clinicians should consider SPT placement as initial treatment for PFUI when simple retrograde cystoscopy is not successful in placement of a urethral catheter.Level of evidenceTherapeutic/Care Management; Level III.

Published
2023

4. The Outcomes of Pelvic Fracture Urethral Injuries Stratified by Urethral Injury Severity: A Prospective Multi-institutional Genitourinary Trauma Study (MiGUTS)

Author

Fendereski, Kiarad, McCormick, Benjamin J, Keihani, Sorena, Hagedorn, Judith C, Voelzke, Bryan, Selph, J Patrick, Figler, Bradley D, Johnsen, Niels V, da Silva, Rodrigo Donalisio, Broghammer, Joshua A, Gupta, Shubham, Miller, Brandi, Burks, Frank N, Eswara, Jairam R, Osterberg, E Charles, Carney, Kenneth J, Erickson, Brad A, Gretzer, Matthew B, Chung, Paul H, Harris, Catherine R, Murphy, Gregory P, Rusilko, Paul, Anderson, Katherine T, Shridharani, Anand, Benson, Cooper R, Alwaal, Amjad, Blaschko, Sarah D, Breyer, Benjamin N, McKibben, Maxim, Schwartz, Ian W, Simhan, Jay, Vanni, Alex J, Moses, Rachel A, and Myers, Jeremy B

Subjects
Reproductive Medicine, Biomedical and Clinical Sciences, Clinical Sciences, Urologic Diseases, Physical Injury - Accidents and Adverse Effects, Clinical Research, Injuries and accidents, Good Health and Well Being, Adult, Humans, Male, Prospective Studies, Retrospective Studies, Pelvic Bones, Urethra, Fractures, Bone, Urethral Diseases, Multiple Trauma, Urethral Obstruction, Urology & Nephrology, Clinical sciences
Abstract

ObjectiveTo determine patient outcomes across a range of pelvic fracture urethral injury (PFUI) severity. PFUI is a devastating consequence of a pelvic fracture. No study has stratified PFUI outcomes based on severity of the urethral distraction injury.MethodsAdult male patients with blunt-trauma-related PFUI were followed prospectively for a minimum of six months at 27 US medical centers from 2015-2020. Patients underwent retrograde cystourethroscopy and retrograde urethrography to determine injury severity and were categorized into three groups: (1) major urethral distraction, (2) minor urethral distraction, and (3) partial urethral injury. Major distraction vs minor distraction was determined by the ability to pass a cystoscope retrograde into the bladder. Simple statistics summarized differences between groups. Multi-variable analyses determined odds ratios for obstruction and urethroplasty controlling for urethral injury type, age, and Injury Severity Score.ResultsThere were 99 patients included, 72(72%) patients had major, 13(13%) had minor, and 14(14%) had partial urethral injuries. The rate of urethral obstruction differed in patients with major (95.8%), minor (84.6%), and partial injuries (50%) (P < 0.001). Urethroplasty was performed in 90% of major, 66.7% of minor, and 35.7% of partial injuries (P < 0.001).ConclusionIn PFUI, a spectrum of severity exists that influences outcomes. While major and minor distraction injuries are associated with a higher risk of developing urethral obstruction and need for urethroplasty, up to 50% of partial PFUI will result in obstruction, and as such need to be closely followed.

Published
2022

14. Evaluation of Generic Versus Condition-Specific Quality of Life Indicators for Successful Urethral Stricture Surgery

Author

Chung, Paul H, Vanni, Alex J, Breyer, Benjamin N, Erickson, Bradley A, Myers, Jeremy B, Alsikafi, Nejd, Buckley, Jill, Elliott, Sean P, Zhao, Lee C, Voelzke, Bryan B, and Network of Surgeons, for the Trauma and Urologic Reconstructive

Subjects
Biomedical and Clinical Sciences, Clinical Sciences, Clinical Research, Pain Research, Chronic Pain, Urologic Diseases, Management of diseases and conditions, 7.1 Individual care needs, Evaluation of treatments and therapeutic interventions, 6.4 Surgery, Good Health and Well Being, Adolescent, Adult, Aged, Aged, 80 and over, Humans, Male, Middle Aged, Patient Reported Outcome Measures, Prospective Studies, Quality of Life, Urethral Stricture, Young Adult, Trauma and Urologic Reconstructive Network of Surgeons, Urology & Nephrology, Clinical sciences
Abstract

ObjectiveTo compare the utility of generic health quality of life (QOL) and condition specific indicators as patient reported outcomes measures for urethral stricture surgery.Materials and methodsPatient data were obtained from the Trauma and Urologic Reconstructive Network of Surgeons collaborative database. Patients who underwent any successful urethroplasty and completed both pre- and postoperative generic and condition-specific questionnaires were included.ResultsA total of 201 patients met inclusion criteria. Urethral-stricture specific measures improved after surgery: mean LUTS score (13.1-4.0, p

Published
2019

16. Surgical and Functional Outcomes Following Buried Penis Repair With Limited Panniculectomy and Split-thickness Skin Graft

Author

Hampson, Lindsay A, Muncey, Wade, Chung, Paul H, Ma, CC, Friedrich, Jeffrey, Wessells, Hunter, and Voelzke, Bryan B

Subjects
Biomedical and Clinical Sciences, Clinical Sciences, Clinical Research, Patient Safety, Urologic Diseases, Evaluation of treatments and therapeutic interventions, 6.4 Surgery, Abdominoplasty, Humans, Male, Middle Aged, Penis, Retrospective Studies, Skin Transplantation, Treatment Outcome, Urologic Surgical Procedures, Male, Urology & Nephrology, Clinical sciences
Abstract

ObjectiveTo report surgical and functional outcomes of buried penis surgery.MethodsOutcomes following buried penis surgery at the University of Washington were assessed from June 1, 2005 to June 1, 2016. Patient demographic and surgical data were abstracted from a retrospective chart review. All patients were attempted to be contacted by phone for long-term follow-up. Uni- and multivariate analysis was performed to evaluate for association with any complication.ResultsA total of 42 men underwent buried penis repair surgery (mean short-term follow-up 8.1 months). There was an overall 33% 90-day complication rate (21 events). In univariate analysis, body mass index (BMI; P = .02) and no history of gastric bypass (P = .03) were significant predictors of any complication. In multivariate analysis, only BMI remained significant (odds ratio 1.1 for each increase in unit of BMI, 95% confidence interval 1.01-1.27). Twenty-seven patients were reached for long-term follow-up (mean 39 months). Patients reported improvements in every functional domain that was assessed. Of the patients, 85% reported they would undergo buried penis surgery again, 74% that surgery led to a positive change in their lives, and 85% that the surgery had remained a long-term success.ConclusionSurgical correction of buried penis with penile split-thickness skin graft and limited panniculectomy is well tolerated and results in functional, long-term improvements. BMI is associated with an increased likelihood of a complication following surgery.

Published
2017

18. Addressing the need for preclinical study of penile prosthesis infection: a new animal model and narrative review

Author

Shah, Yash B., primary, Liu, Ji-Bin, additional, Machado, Priscilla, additional, Denisenko, Andrew, additional, Wessner, Corinne E., additional, Wang, Kerith R., additional, Simhal, Rishabh K., additional, Isguven, Selin, additional, Delaney, Lauren J., additional, Hickok, Noreen J., additional, Forsberg, Flemming, additional, and Chung, Paul H., additional

Published
2024
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33. The Outcomes of Pelvic Fracture Urethral Injuries Stratified by Urethral Injury Severity: A Prospective Multi-institutional Genitourinary Trauma Study (MiGUTS)

Author

Fendereski, Kiarad, primary, McCormick, Benjamin J., additional, Keihani, Sorena, additional, Hagedorn, Judith C., additional, Voelzke, Bryan, additional, Selph, J. Patrick, additional, Figler, Bradley D., additional, Johnsen, Niels V., additional, da Silva, Rodrigo Donalisio, additional, Broghammer, Joshua A., additional, Gupta, Shubham, additional, Miller, Brandi, additional, Burks, Frank N., additional, Eswara, Jairam R., additional, Osterberg, E. Charles, additional, Carney, Kenneth J., additional, Erickson, Brad A., additional, Gretzer, Matthew B., additional, Chung, Paul H., additional, Harris, Catherine R., additional, Murphy, Gregory P., additional, Rusilko, Paul, additional, Anderson, Katherine T., additional, Shridharani, Anand, additional, Benson, Cooper R., additional, Alwaal, Amjad, additional, Blaschko, Sarah D, additional, Breyer, Benjamin N., additional, McKibben, Maxim, additional, Schwartz, Ian W., additional, Simhan, Jay, additional, Vanni, Alex J., additional, Moses, Rachel A., additional, and Myers, Jeremy B., additional

Published
2022
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37. A multicenter prospective cohort study of endoscopic urethral realignment versus suprapubic cystostomy after complete pelvic fracture urethral injury

Author

McCormick, Benjamin J., primary, Keihani, Sorena, additional, Hagedorn, Judith, additional, Selph, J. Patrick, additional, Figler, Bradley D., additional, Johnsen, Niels V., additional, da Silva, Rodrigo Donalisio, additional, Broghammer, Joshua A., additional, Gupta, Shubham, additional, Miller, Brandi, additional, Burks, Frank N., additional, Eswara, Jairam, additional, Osterberg, E. Charles, additional, Carney, Kenneth J., additional, Erickson, Bradley A., additional, Gretzer, Matthew B., additional, Chung, Paul H., additional, Harris, Catherine R., additional, Murphy, Gregory P., additional, Rusilko, Paul, additional, Shridharani, Anand, additional, Benson, Cooper, additional, Alwaal, Amjad, additional, Blaschko, Sarah D., additional, Breyer, Benjamin N., additional, Amend, Gregory M., additional, McKibben, Maxim, additional, Elliott, Sean P., additional, Schwartz, Ian W., additional, Simhan, Jay, additional, Vanni, Alex J., additional, Moses, Rachel A., additional, and Myers, Jeremy B., additional

Published
2022
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47. Magnetic Resonance Imaging/Ultrasound Fusion Guided Prostate Biopsy Improves Cancer Detection Following Transrectal Ultrasound Biopsy and Correlates With Multiparametric Magnetic Resonance Imaging

Author

Pinto, Peter A., Chung, Paul H., Rastinehad, Ardeshir R., Baccala, Angelo A., Jr., Kruecker, Jochen, Benjamin, Compton J., Xu, Sheng, Yan, Pingkun, Kadoury, Samuel, Chua, Celene, Locklin, Julia K., Turkbey, Baris, Shih, Joanna H., Gates, Stacey P., Buckner, Carey, Bratslavsky, Gennady, Linehan, W. Marston, Glossop, Neil D., Choyke, Peter L., and Wood, Bradford J.

Published
2011
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