It is rare, complicated injuries, associated with massive soft tissue loss, end with long strictures.
It is caused by terrorist attacks by adhesive bombs that fixed below the seat of the car driver. we faced many cases in the last decade, they were so challenging cases.
any experience with such cases?
Dear Azzawi Hadi,
though I have no cases of urethral shell injury (It does not take place in Poland) I have an profound experience with pelvic fracture distarction deffect caused by crash injury (industrial and motorbikes). My patients have no urethra - it is plucked away. Last case (he rode his motorbike 200km/h) had PFUDD with destroyed rectum. So he had reconstruction of posterior urethra, bladder neck and rectum. Is going well. In hopeless cases I strongly recommend You Johanson staged procedure - it works.
If You have any cuestions please do not hesitate. You mah call me too (by Facetime my mail address: [email protected]).
Additionally in two cases a laking segment of the urethra has been replaced by autologous in vitro developed neo-urethra created in vitro from mall amount of cells taken from patients and developed in tissue lab which I lead some yeras ago. One guy was after car accident, had 5 previous and failed reconstructive surgery and finally was offered an ileobladder.
After developing in vitro an 8 cm segment I transplanted this and it works - it was almost 10 years ago. Now he is a movie actor in soap-operas in Poland. This case was presented during EAU congress in Birmingham and I got s second prize for this but this method is expensive and time consuming.
During a Congress of Polish Urological Association which will take place in 11-14 june i will present a lecture:"Hybrid staged urethroplasty. Novel development of Johanson procedure for complex posterior urethral injury".
I think it may be interesting for You so You are welcomed. It is about cases of completely crushed posterior urethra repair with own modification which I called hybrid.
traditional and conventional way still work and can help our patients...
thank you alot for sharing these information.
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