Early Realignment Versus Delayed Urethroplasty in Management of Pelvic Fracture Urethral Injury: A Meta-analysis
ABSTRACT: this meta-analysis
study will evaluate the incidence of urethral stricture as a successfull
parameter in the management of PFUI through early realignment, compared with
delayed urethroplasty. Long-term complications such as erectile dysfunction and
incontinence on both methods will also be evaluated. Methods: online literature
was sourced from Pubmed, Embase, Cochrane, and Google Scholar. The incidence of
stricture was evaluated from the entire study group of ER and DU. Stricture of
the urethra is diagnosed by the symptoms such as the obstruction that felt by
the patient, uroflowmetry examination, and urine residual post micturition that
supported by urethrography examination at regular interval. In some cases the
incidence of stricture also diagnosed by urethroscopy. The patient is assessed
as not having stricture when it is no longer needed to do urethral dilatation
or advanced urethrotomy. The rate of incontinence was assessed subjectively
from the patient’s complaints. The erectile function assessed subjectively;
decreased of tumesen’s degree, reduced the duration of erection, and
penetration failure diagnosed as erection dysfunction. The data were processed
as dichotomy data to calculate the risk ratio using Review Manager 5.1.
Results: fve relevant literatures reviewed in this study. The incidence of
urethral strictures are statistically signifcant lower in early realignment
group (RR=0.70, 95% CI 0.50-0.99, P<0.05). There were no statistically
signifcant differences between both treatment groups on the incidence of
erectile dysfunction (RR=0.72, 95% CI 0.39-1.34) nor the incidence of
incontinence (RR=0.74, 95% CI 0.36-1.51). Conclusion: early realignment
decrease the occurrence of stricture on PFUI treatment compared to delayed
urethroplasty method. Between the two methos, the complications such as
erectile dysfunction and incontinence; however, there was no signifcant
difference.
Author: Rama Firmanto, Gampo
A. Irdam, Irfan Wahyudi
Journal Code: jpkedokterangg160010
