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Urethral injury risk following pelvic fractures during period 2013-2016: a single center experience at Dr. Kariadi Hospital

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Introduction
Pelvic fracture urethral injuries (PFUI) incidence occurs in as many as 24% of adults with pelvic fracture (PF). Urethral injury is a common complication of pelvic trauma that, if undiagnosed, may lead to significant long-term morbidity
Objective
We analyses to identify descriptive profile of patient that was treated at dr. Kariadi hospital during January 2013 – December 2016 with PFUI, severity of urethral injury, management, monitoring the result of treatment, number of operation, and complication after urethral repair procedure.
Materials & Methods
Patient that was hospitalized during period of January 2013 – December 2016 at Dr Kariadi hospital was recorded from medical record database. We complete missing data by calling the study subject by phone.
Result
Total sample population patient 34 PF patients (22 male, 12 female). Population age grouped to < 18, 18-50, and > 50 yrs. old, there are 3, 22, and 9 patients respectively. From male and female PFUI group we obtained 20 and 2 patients respectively. Straddle injury is the top causal of PFUI, second top is domestic accident of slip and fall down with sitting position, and falling objects that hit the patient on pelvic region. Above we can know that fracture of AP compression type is the most common cause of fracture that causes urethral injury (p=0.064), the posterior part of the urethra is the most frequently injured part caused by the pelvic fracture. The early procedure (PER) is the most commonly used treatment for the rupture of the posterior urethra (p=0.329). In this study it was found that micturition flow after operation is better in early procedure than late procedure (0.729), so the stricture of the urethra is usually happened in the late procedure. And urinary incontinence is 21,67 times (OD= 21,667) better in early procedure than in late procedure (.225)
Conclusion
1. Incidence of PF is higher in productive ages (18 – 50 yrs), and more common caused by motorcycles traffic accident.
2. Posterior part of urethra is the most commonly injured and AP compression type fracture is the most common cause of uretral injury.
3. The early procedure (PER) is the most commonly used treatment for the rupture of the posterior urethra and the AP compression type PFUI in this study.
4. Controversies of urethral injury repair with Early or Delayed methods, our study shows that micturition flow after operation is 39 times (OD=39,00) better in early procedure than late procedure (p=0.002), so the stricture of the urethra is usually happened in the late procedure. And urinary incontinence is 21,67 times (OD= 21,667) better in early procedure than in late procedure.
5. Urethral reconstruction is likely to give less complication about persistent urethral stricture compare to others method.
Keyword : pelvic fractures, urethral injury, urethroplasty, erectile dysfunction

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Ketersediaan — Fakultas Kedokteran

Informasi Detail

Judul Seri

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No. Panggil

617 MIC u

Penerbit

Semarang : FK Undip., 2020

Deskripsi Fisik

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Bahasa

English

ISBN/ISSN

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Klasifikasi

617

Tipe Isi

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Tipe Media

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Tipe Pembawa

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Edisi

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Subjek

Surgery

Info Detail Spesifik

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Pernyataan Tanggungjawab

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Versi lain/terkait

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