The Flexible Cystoscope For Evaluating Pelvic Fracture Urethral Distraction Defects

OBJECTIVE: To describe the value of flexible cystoscopy versus conventionalurethrography (retrograde urethrography,RUG&cysto-urethrography,CUG) indiagnosing the Pelvic fracture urethral distraction defects (PFUDDs)PATIENTS AND METHODS: Between May2010and June2011,120malepatients with PFUDDs have been evaluated. In this study, all patients were undergoneconventional urethrography after admission. Flexible cystoscope was also used forcomparsion followed by conventional urethrography. The flexible cystoscope wasintroduced into the posterior urethra and the area was evaluated for the length of theproximal urethra and any probable fistula, false passages, calculus or displacement ofthe posterior urethra.RESULTS: Severe allergic reaction or obviously discomfortable didn’t occure inpatients after the conventional urethrography or flexible cystoscope. By comparingthe data obtained from flexible cystoscope to those from conventional urethrography,no statistical difference was found in the measured length of proximal posteriorurethra(4.31±2.28vs4.02±3.12p>0.05). However, the rate of accuracy in the otherabnormality was higher in flexible cystoscope than that in conventional urethrography(48.3%vs9.2%p<0.05). Among them,17(14.2%),9(7.5%),32(26.7%) werenoticed fistula, false passage, calculus according to the flexible cystoscope.Nevertheless, the fistula, false passage, calculus were only observed in2(1.7%),5(4.2%),4(3.3%) patients through the image of conventional urethrographyrespectively.CONCLUSIONS: Flexible cystoscopy is a valuable procedure in the evaluationof the posterior urethra, bladder neck, and in patients with urethral distraction defectsbefore the surgery. More details about the fistula, false passage, calculus and urethraldefect could be obtained through this method. Flexible cystoscopy combined RUG and VCUG may provide more accurate and more immediate information of diagnosisand surveillance in patients...