The following is a summary of “Clinical observation of male bulbar urethral strictures resulting from straddle injuries associated with falling from heights and riding activities,” published in the May 2024 issue of Surgery by Li et al.
This retrospective study aimed to investigate and analyze the characteristics of male bulbar urethral strictures or occlusions resulting from straddle injuries caused by falls from heights and riding activities.
The study included 56 patients with a history of straddle injury, divided into two groups: the falling group (n = 29) and the riding group (n = 27). All patients underwent urethroscopy and X-ray urethrography, followed by urethrotomy and anastomotic procedures. Both urethral and suprapubic catheters were retained for one month postoperatively, with follow-up assessments conducted within one month to one year after surgery.
Clinical data were analyzed for both groups. The average age in the falling group was 40.1 ± 11.2 years (range 18-59), while in the riding group, it was 26.8 ± 4.4 years (range 19-35), showing a significant difference (P < 0.05). In the falling group, 21 patients (72.4%) had offspring, compared to only 3 patients (11.1%) in the riding group (P < 0.05). Stricture segments in the falling group were predominantly located in the proximal part of the bulbar region (89.7%), whereas in the riding group, they were mainly in the distal part (96.3%) (P < 0.05). Urethrography results indicated the average lengths of stricture segments were 17.6 ± 2.8 mm in the falling group and 15.5 ± 4.6 mm in the riding group (P < 0.05). During surgery, the average lengths were 19.0 ± 2.5 mm and 17.4 ± 6.1 mm, respectively (P > 0.05). In the falling group, 20 patients (69.0%) had bulbocavernosus muscle injury (P < 0.05), while in the riding group, 5 patients (18.5%) had corpus cavernosum injury (P < 0.05).
All patients could pass a 16Fr urethroscope one month post-operation without apparent urethral strictures or complications on urethrography. The maximum urinary flow rate exceeded 15 ml/s for all patients. At two months and one year post-operation, all patients experienced smooth urinary flow and ejaculation without reported disorders. However, 3 patients (10.3%) in the falling group and 7 patients (25.9%) in the riding group reported urethral stretching pain during erection (P > 0.05).
In conclusion, male bulbar urethral strictures or occlusions resulting from straddle injuries due to falls from heights and riding activities exhibit distinct characteristics. These findings underscore the need for a comprehensive surgical plan tailored to the specific features of each condition and the diverse age groups affected.
Source: bmcsurg.biomedcentral.com/articles/10.1186/s12893-024-02435-x
