{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,12]],"date-time":"2026-10-12T00:31:11Z","timestamp":1791765071962,"version":"4.3.4"},"reference-count":27,"publisher":"MDPI AG","issue":"1","license":[{"start":{"date-parts":[[2022,12,21]],"date-time":"2022-12-21T00:00:00Z","timestamp":1671580800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Introduction: The management of traumatic urethral strictures remains a challenge for urologists. Alteration of the pelvic anatomy and the significant fibrosis generated by the trauma make surgical repair complex. In most cases, the existing defect between the urethral ends is small, and the ideal treatment is end-to-end perineal urethroplasty. Cases of extensive strictures that are left with long gap defects may require the use of different sequential maneuvers to achieve a tension-free anastomosis. Objective: To describe the experience at our center with urethral strictures induced by closed perineal trauma. Materials and methods: A retrospective analysis of 116 patients who underwent urethroplasty for urethral stricture after blunt perineal trauma at our center between 1965 and 2020 was conducted. Demographic data, date, mechanism of action of the trauma, emergency management, previous urethral interventions, surgical technique carried out in our center, complications, presence of erectile dysfunction, and urinary incontinence were collected. Results: 82 patients (70.7%) presented with pelvic fractures. The most frequent etiology of trauma was traffic accidents (68%), followed by crushing injuries (24%). Suprapubic cystostomy was placed in 50.2% of patients, and urethral realignment was performed in 25.3%. The mean stricture length was 2.2 cm, affecting mostly the membranous urethra (67%). During surgery, it was necessary to perform crural separation in 61.5% and partial pubectomy in 18.8% of the cases. Erectile dysfunction developed after trauma in 40.5% of cases, while new erectile dysfunction was noted in 4.3% of patients after surgery. Surgery was successful in 91.3% of cases, with a median follow-up of 16 (6\u201347) months. Conclusion: Delayed anastomotic urethroplasty offers a high success rate in traumatic urethral strictures.<\/jats:p>","DOI":"10.3390\/jcm12010054","type":"journal-article","created":{"date-parts":[[2022,12,22]],"date-time":"2022-12-22T02:31:11Z","timestamp":1671676271000},"page":"54","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Repair of Traumatic Urethral Strictures: La Paz University Hospital Experience"],"prefix":"10.3390","volume":"12","author":[{"given":"Cristina","family":"Ballesteros Ruiz","sequence":"first","affiliation":[{"name":"Urology Department, Hospital Universitario La Paz, Paseo de la Castellana 261, 28046 Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carlos","family":"Toribio-V\u00e1zquez","sequence":"additional","affiliation":[{"name":"Urology Department, Hospital Universitario La Paz, Paseo de la Castellana 261, 28046 Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2602-2617","authenticated-orcid":false,"given":"Esa\u00fa","family":"Fern\u00e1ndez-Pascual","sequence":"additional","affiliation":[{"name":"Urology Department, Hospital Universitario La Paz, Paseo de la Castellana 261, 28046 Madrid, Spain"},{"name":"Instituto de Investigaci\u00f3n Hospital Universitario La Paz (IDiPaz), Calle de Pedro Rico, 6, 28029 Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emilio","family":"R\u00edos","sequence":"additional","affiliation":[{"name":"Urology Department, Hospital Universitario La Paz, Paseo de la Castellana 261, 28046 Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrea","family":"Rodr\u00edguez Serrano","sequence":"additional","affiliation":[{"name":"Urology Department, Hospital Universitario La Paz, Paseo de la Castellana 261, 28046 Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J. M.","family":"Alonso Dorrego","sequence":"additional","affiliation":[{"name":"Urology Department, Hospital Universitario La Paz, Paseo de la Castellana 261, 28046 Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Manuel","family":"Gir\u00f3n de Francisco","sequence":"additional","affiliation":[{"name":"Urology Department, Hospital Universitario La Paz, Paseo de la Castellana 261, 28046 Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J. A.","family":"Moreno","sequence":"additional","affiliation":[{"name":"Urology Department, Hospital Universitario La Paz, Paseo de la Castellana 261, 28046 Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paloma","family":"C\u00e1rcamo Valor","sequence":"additional","affiliation":[{"name":"Urology Department, Hospital Universitario La Paz, Paseo de la Castellana 261, 28046 Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luis","family":"Mart\u00ednez-Pi\u00f1eiro","sequence":"additional","affiliation":[{"name":"Urology Department, Hospital Universitario La Paz, Paseo de la Castellana 261, 28046 Madrid, Spain"},{"name":"Instituto de Investigaci\u00f3n Hospital Universitario La Paz (IDiPaz), Calle de Pedro Rico, 6, 28029 Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2022,12,21]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"876","DOI":"10.1046\/j.1464-410X.1996.01119.x","article-title":"Risk factors and mechanism of urethral injury in pelvic fractures","volume":"77","author":"Koraitim","year":"1996","journal-title":"Br. J. Urol."},{"key":"ref_2","first-page":"9","article-title":"Indications and techniques for urologic evaluation of the trauma patient with suspected urologic injury","volume":"13","author":"Carlin","year":"1995","journal-title":"Semin. Urol."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"791","DOI":"10.1016\/j.eururo.2010.01.013","article-title":"EAU Guidelines on Urethral Trauma","volume":"57","author":"Djakovic","year":"2010","journal-title":"Eur. Urol."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"327","DOI":"10.1016\/j.juro.2014.05.004","article-title":"Urotrauma: AUA guideline","volume":"192","author":"Morey","year":"2014","journal-title":"J. Urol."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"898","DOI":"10.1016\/S0022-5347(17)51561-X","article-title":"Prostatomembranous urethral injuries: A review of the literature and a rational approach to their management","volume":"130","author":"Webster","year":"1983","journal-title":"J. Urol."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"297","DOI":"10.1016\/S0094-0143(21)01509-3","article-title":"Pubectomy in repair of membranous urethral stricture","volume":"16","author":"McAninch","year":"1989","journal-title":"Urol. Clin. N. Am."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"596","DOI":"10.1111\/iju.13947","article-title":"Management of male pelvic fracture urethral injuries: Review and current topics","volume":"26","author":"Horiguchi","year":"2019","journal-title":"Int. J. Urol."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"2006","DOI":"10.1016\/j.juro.2007.07.020","article-title":"Urethral reconstruction for traumatic posterior urethral disruption: Outcomes of a 25-year experience","volume":"178","author":"Cooperberg","year":"2007","journal-title":"J. Urol."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"135","DOI":"10.1097\/01.ju.0000146683.31101.ff","article-title":"On the art of anastomotic posterior urethroplasty: A 27-year experience","volume":"173","author":"Koraitim","year":"2005","journal-title":"J. Urol."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"1877","DOI":"10.1097\/01.ju.0000091642.41368.f5","article-title":"Perineal repair of pelvic fracture urethral distraction defects: Experience in 120 patients during the last 10 years","volume":"170","author":"Flynn","year":"2003","journal-title":"J. Urol."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"1378","DOI":"10.1016\/j.juro.2006.11.036","article-title":"Simplified reconstruction of posterior urethral disruption defects: Limited role of supracrural rerouting","volume":"177","author":"Kizer","year":"2007","journal-title":"J. Urol."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"1073","DOI":"10.1007\/s00345-019-02824-5","article-title":"Multicenter analysis of posterior urethroplasty complexity and outcomes following pelvic fracture urethral injury","volume":"38","author":"Johnsen","year":"2020","journal-title":"World J. Urol."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"744","DOI":"10.1016\/S0022-5347(17)38442-2","article-title":"Repair of pelvic fracture posterior urethral defects using an elaborated perineal approach: Experience with 74 cases","volume":"145","author":"Webster","year":"1991","journal-title":"J. Urol."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"1132","DOI":"10.1016\/j.urology.2009.05.078","article-title":"Transperineal Bulboprostatic Anastomosis in Patients With Simple Traumatic Posterior Urethral Strictures: A Retrospective Study from a Referral Urethral Center","volume":"74","author":"Fu","year":"2009","journal-title":"Urology"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"1288","DOI":"10.1016\/S0022-5347(01)65571-X","article-title":"Pelvic fracture urethral injuries: Evaluation of various methods of management","volume":"156","author":"Koraitim","year":"1996","journal-title":"J. Urol."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"291","DOI":"10.1016\/S0094-0143(21)01508-1","article-title":"Primary realignment of the disrupted prostatomembranous urethra","volume":"16","author":"Devine","year":"1989","journal-title":"Urol. Clin N. Am."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"873","DOI":"10.1097\/01.ju.0000152145.33215.36","article-title":"The treatment of posterior urethral disruption associated with pelvic fractures: Comparative experience of early realignment versus delayed urethroplasty","volume":"173","author":"Mouraviev","year":"2005","journal-title":"J. Urol."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"869","DOI":"10.1016\/j.juro.2017.04.081","article-title":"The Immediate Management of Pelvic Fracture Urethral Injury-Endoscopic Realignment or Cystostomy?","volume":"198","author":"Zou","year":"2017","journal-title":"J. Urol."},{"key":"ref_19","doi-asserted-by":"crossref","unstructured":"Tile, M., and Pennal, G.F. (1980). Pelvic disruption: Principles of management. Clin. Orthop. Relat. Res., 56\u201364.","DOI":"10.1097\/00003086-198009000-00009"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"912","DOI":"10.1016\/j.urology.2011.11.054","article-title":"Effect of early realignment on length and delayed repair of postpelvic fracture urethral injury","volume":"79","author":"Koraitim","year":"2012","journal-title":"Urology"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"2169","DOI":"10.1007\/s00345-015-1533-4","article-title":"Factors that influence the outcome of open urethroplasty for pelvis fracture urethral defect (PFUD): An observational study from a single high-volume tertiary care center","volume":"33","author":"Fu","year":"2015","journal-title":"World J. Urol."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"1374","DOI":"10.1016\/j.juro.2006.11.092","article-title":"Anastomotic urethroplasty for posttraumatic urethral stricture: Previous urethral manipulation has a negative impact on the final outcome","volume":"177","author":"Culty","year":"2007","journal-title":"J. Urol."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"179","DOI":"10.1016\/j.urology.2009.06.081","article-title":"Impact of prior urethral manipulation on outcome of anastomotic urethroplasty for post-traumatic urethral stricture","volume":"75","author":"Singh","year":"2010","journal-title":"Urology"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"1049","DOI":"10.1016\/j.juro.2009.11.045","article-title":"Posterior urethral stricture after pelvic fracture urethral distraction defects in developing and developed countries, and choice of surgical technique","volume":"183","author":"Kulkarni","year":"2010","journal-title":"J. Urol."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"50","DOI":"10.1016\/S0022-5347(17)40583-0","article-title":"Internal urethrotomy as a complementary method after urethroplasties for posterior urethral stenosis","volume":"141","author":"Netto","year":"1989","journal-title":"J. Urol."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"506","DOI":"10.1016\/S0022-5347(01)65188-7","article-title":"Reconstruction of Posterior Urethral Disruption Injuries: Outcome Analysis in 82 Patients","volume":"157","author":"Morey","year":"1997","journal-title":"J. Urol."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"433","DOI":"10.1159\/000480803","article-title":"Excision and anastomotic repair for urethral stricture disease: Experience with 150 cases","volume":"32","author":"Carcamo","year":"1997","journal-title":"Eur. Urol."}],"container-title":["Journal of Clinical Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-0383\/12\/1\/54\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T01:46:59Z","timestamp":1760147219000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-0383\/12\/1\/54"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,12,21]]},"references-count":27,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2023,1]]}},"alternative-id":["jcm12010054"],"URL":"https:\/\/doi.org\/10.3390\/jcm12010054","relation":{},"ISSN":["2077-0383"],"issn-type":[{"value":"2077-0383","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,12,21]]}}}