Abstract：Objective To compare the curative effect of several surgical treatments for closed urethral injury.Methods A retrospective study was done on 200 cases of closed urethral injury treated with various methods from June 2002 to June 2012,including 44 cases of anterior urethral injury treated with endoscopic transurethral realignment (anterior endoscopic group),32 cases of anterior urethral injury with transperineal urethral repair (repair group),42 cases of posterior urethral injury with transperineal urethral termino-terminal anastomosis (anastomosis group),35 cases of posterior urethral injury with endoscopic transurethral realignment (posterior endoscopic group),and 47 cases of posterior urethral injury with endoscopic transurethral and transvesical realignment (combined endoscopic group).Amount of bleeding,operation time,hospital stay as well as expense,and rate of urethral stricture and erectile dysfunction (ED) in treatment of anterior and posterior urethral injury were compared respectively.Curativeeffect and merits and faults of each treatment were observed.Results Anterior endoscopic group achieved less bleeding [(10 ± 5) ml∶ (100 ± 20) ml,P ＜ 0.05],shorter operation time and hospital stay [(15 ± 6) min∶ (40 ± 15) min,(14.2 ± 1.8) min∶ (28.5 ± 1.5) min respectively,P ＜ 0.05],lower hospital expense and urethral stricture rate[(4 715.42 ± 225.43) RMB∶ (6 886.46 ± 246.78) RMB,39％ ∶ 63％ respectively,P ＜ 0.05] as compared with repair group,but there was no statistical difference in ED rate between the two groups.Whereas in anastomosis group,the most bleeding [(200 ± 30) ml],longest operation time [(60 ± 20) minutes] and hospital stay [(28.7 ± 2.3) days],and highest hospital expense [(6 964.27 ± 275.69) RMB] and urethral stricture rate (95 ％) were detected (P ＜ 0.05).Posterior endoscopic group presented less bleeding [(15 ± 6) ml∶ (50 ± 12) ml,P ＜ 0.05] and shorter operation time [(21.4 ± 1.7) min∶ (21.2 ± 1.5) min,P ＜ 0.05] as compared with combined endoscopic group,but there were no statistical differences in hospital stay as well as expense and urethral stricture rate between the two groups.Moreover,ED rate was not statistically different among anastomosis group,posterior endoscopic group and combined endoscopic group.Conclusions Endoscopic surgery is superior to traditional surgery in terms of blood loss,operation time,hospital stay,and hospital cost.Besides,urethral stricture and ED rates are closely related to the location and severity of injury.
