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Background <p>Accurate preoperative planning is vital for successful surgical repair of pelvic fracture urethral injuries (PFUI). Magnetic resonance urethrography (MRU) offers a more detailed anatomical assessment of the posterior urethra than conventional urethrography. This study evaluates the role of MRU in PFUI repairs.</p> Methods <p>This was a prospective, single-center observational study conducted at a tertiary academic institution between August 2022 and December 2024, aimed at correlating the surgical complexity of PFUI repairs with preoperative geometric parameters derived from MRU and conventional urethrography. Male patients aged ≥ 18 years diagnosed with PFUI were included.</p> Results <p>Twenty male patients were studied, with a median age of 26&#xa0;years (IQR: 20.5–36). The bulbomembranous urethra was the most frequent site of disruption (80%). Mean urethral gap measured 2.68 cm (SD 1.13) on MRU and 3.09 cm (SD 1.19) on conventional urethrography. Thirteen patients (65%) underwent non-pubectomy urethroplasty (NPU), and 7 underwent urethroplasty with pubectomy (PU). Within the NPU group, urethral mobilization sufficed in five, while eight required additional corporal separation. On MRU, mean distraction defect was significantly greater in the PU group (3.55 vs 2.22 cm in the NPU group, <i>p</i> &lt; <i>0.01</i>). Both MRU and conventional urethrography performed well on concordance analysis against the true gap length, with concordance correlation coefficients of 0.969 and 0.894 respectively.</p> Conclusion <p>Magnetic resonance urethrography (MRU) provides a more comprehensive and precise preoperative evaluation of PFUI compared to conventional urethrography, offering better visualization of the prostatic urethra, accurate gap measurement along with assessment of periurethral anatomic relationships.</p>

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Magnetic resonance urethrography-derived geometric parameters and their association with surgical complexity in pelvic fracture urethral injury repair

  • 期刊论文

  • 发表日期：

    2026年4月23日

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  • Ishory Bhusal,
  • Siddharth Jain,
  • Mehul Gupta,
  • Stuti Chandola,
  • Sanjay Sharma,
  • Amlesh Seth,
  • Rishi Nayyar,
  • Manoj Kumar,
  • Sanjay Kumar

摘要

Background

Accurate preoperative planning is vital for successful surgical repair of pelvic fracture urethral injuries (PFUI). Magnetic resonance urethrography (MRU) offers a more detailed anatomical assessment of the posterior urethra than conventional urethrography. This study evaluates the role of MRU in PFUI repairs.

Methods

This was a prospective, single-center observational study conducted at a tertiary academic institution between August 2022 and December 2024, aimed at correlating the surgical complexity of PFUI repairs with preoperative geometric parameters derived from MRU and conventional urethrography. Male patients aged ≥ 18 years diagnosed with PFUI were included.

Results

Twenty male patients were studied, with a median age of 26 years (IQR: 20.5–36). The bulbomembranous urethra was the most frequent site of disruption (80%). Mean urethral gap measured 2.68 cm (SD 1.13) on MRU and 3.09 cm (SD 1.19) on conventional urethrography. Thirteen patients (65%) underwent non-pubectomy urethroplasty (NPU), and 7 underwent urethroplasty with pubectomy (PU). Within the NPU group, urethral mobilization sufficed in five, while eight required additional corporal separation. On MRU, mean distraction defect was significantly greater in the PU group (3.55 vs 2.22 cm in the NPU group, p < 0.01). Both MRU and conventional urethrography performed well on concordance analysis against the true gap length, with concordance correlation coefficients of 0.969 and 0.894 respectively.

Conclusion

Magnetic resonance urethrography (MRU) provides a more comprehensive and precise preoperative evaluation of PFUI compared to conventional urethrography, offering better visualization of the prostatic urethra, accurate gap measurement along with assessment of periurethral anatomic relationships.