Endoscopic Management of Penetrating Urethral Injury After an Animal Attack

Abstract

Background: Initial management of urethral injury remains controversial concerning the use of suprapubic urinary diversion and delayed repair, primary open realignment, and primary endoscopic realignment. To our knowledge, we present the first reported case of a penetrating urethral injury because of an animal attack, without concomitant extragenitourinary system involvement, managed entirely endoscopically. Case Presentation: This is a case of an 82-year-old male who presented to the emergency department after an attack by a semidomesticated deer. He presented with a penetrating scrotal injury and gross blood at the meatus. A retrograde urethrogram was performed that revealed a urethral injury. Surgical exploration revealed an isolated 3-cm urethral defect. It was managed with primary endoscopic placement of a urethral catheter and suprapubic tube. Conclusion: Although initial management of urethral injuries remains controversial, an isolated urethral injury after a penetrating trauma because of an animal attack may be safely and effectively managed by primary endoscopic realignment.