Trauma & Others(구연) (E-230) Surgical Outcome of Urethral Reconstruction for Pelvic Fracture Urethral Injury 서울대학교 의과대학 비뇨기과학교실 정규환, 김수웅 Purpose: We performed a retrospective evaluation and statistical analysis of surgical outcome in patients who underwent urethral recontruction for pelvic fracture urethral injury (PFUI). Materials and Methods: We reviewed 61 patients 21 to 71 years old (mean 49.7) with at least 12 months of follow-up after posterior urethroplasty for PFUI by a single surgeon. The urethral injuries were most commonly due to road traffic accidents (68.9%). A total of 34 patients (55.7%) underwent primary realignment, end-to-end anastomosis, direct vision internal urethrotomy (DVIU), dilation, or multiple treatments before referral to our center. Success was defined to include recurrence managed successfully with a single DIVU or dilation. Results: Mean operation time was 197 minutes (range, 100-360 minutes) and mean stricture length was 2.9 cm (range, 1.5-5 cm). At a mean follow-up of 45.6 months (range, 12-60 months), overall success rate was 82.0%. Failures were treated with repeat DVIU/dilation (n=8) and/or urethroplasty (n=3). Three of these patients finally reached success, two improved, and the others failed. On univariate analysis, unsuccessful primary realignment, longer stricture length, shorter proximal urethral length (distance between the bladder neck and the distal end of the stricture) and initially performed cases (< 30 cases) were predictors to failure. However, none of the factors were identified as independent predictors for surgical outcomes on multivariate analysis. Conclusions: Posterior urethroplasty provides an acceptable success rate for patients following PFUI. However, in order to get better results and to elucidate what factors affect surgical outcomes, more surgical experience is required. keywords : Pelvic fracture urethral injury, Posterior urethroplasty