674
92224226014562119
VIDEO852207016978121223301405
Ces8507936014570127174
Urol10497936014578115180208
2020;12827936014562121178237261
24(2):15697936014561118151210240262
90–9318567936014562124187247305
SUMMARY852884014762143243345423493561
Drlík10001048013171103126148196
P,1220104801316266
Čermák13171048013163114146236284330
M.16781048013186106
Bulbar18081048013163120142202252283
urethral2115104801316597148181239271320343
reconstruc‑2482104801313991140196255294329360419467494
tion850119801313456113171
after1041119801314977114165196
extensive12571198013153100136187244283304353404
inflammatory1685119801311976101127176264352400432488519571
abscess-forming22761198013149108148196247286326356385442473563584641700
process850134801316091146194243282321
in1194134801311975
the1292134801312986137
perineal14481348013160113143165221272319340
region1812134801312777136157213270
due21011348013159115166
to2290134801313084
an23931348013149106
underlying25181348013157113171223253275322344400458
foreign850149801312986118170191250308
body.11821498013161120180229242
Introduction:1000164601332686121157216278338386425449509570591
Injuries161516480131197799155186209261301
to1940164801313086
the2050164801313088141
bulbar22111648013161118140199249280
urethra2511164801315990141174232263312
are2844164801314980132
often850179801315885122171228
isolated.1101179801311856113135182213263322339
They14591798013151109161207
account1685179801314996142196253309340
for2048179801312480111
approximately21771798013150108166197252297318405453484533555602
10%2798179801315298178
of850194801315886
lower960194801311976154205236
urinary1216194801315888111167216246297
tract1537194801313061110158194
injuries175519480131197597153184206258297
and20721948013150107166
35%22571948013154103179
of2456194801315886
all256219480131497192
injuries267819480131197697153184206258298
to850209801313490
the964209801313189143
urethra.1128209801315890141174232263313332
They14822098013151111164212
typically1718209801313182143166214264286308356
include2098209801312078126148205265318
various24372098013150100131153211269308
nonpenetrating276720980131591171768502248013161115173226259291340373395452512
straddle1386224801314075106156216275297350
injuries1760224801312380102159190213265305
(falls2089224801312955106128149188
astride2301224801315089124156178237290
or2615224801315890
kicks).2729224801314670118163207232247
However,8502398013168125201251299349379392
injuries126523980131187495150180201252291
due15752398013159114166
to1764239801312983
instrumental1870239801311974112146176233320371427458506527
manipulation24162398013189136192213270327348395426447503560
(catheterization,850254801312974124157215268302353385407451503535557615674692
endoscopic15672548013161119179238278327383444467515
procedures)21062548013169102158208259320377409461501526
are2656254801315990142
the28222548013142101154
most8502698013190148188223
common10972698013155111201290348407
occurrence.15282698013165114161218249281333391440490507
Urethral20662698013169100151184242273323345
injury2436269801312986108165196248
is2708269801312968
also2801269801315678117175
encountered8502848013153111160216274332363414446497557
in1432284801312077
the1533284801313189142
case1697284801314998138191
of1909284801315987
foreign2020284801312683115167189248305
body23472848013160119180228
insertion2599284801312078117170202239261318377
for850299801312985117
the990299801313088140
purpose11502998013160118148208267306359
of1529299801315886
masturbation.16342998013190138177211268299359408440462519576595
The22492998013151110162
vast2431299801314999138172
majority26232998013189137159216248270303353
of850314801315987
such961314801313894143201
cases1182314801314999139192232
result1438314801312981121178200233
in1695314801312077
penile17933148013161115173194216269
urethral2083314801315890141174232263313336
injury.244331480131197799156187239252
When27163148013190149202260
foreign850329801312884115165186244300
bodies11693298013160118177198249288
are1476329801314980130
inserted1629329801311975113165195231281340
into1992329801311875105160
the2175329801313086138
urethra,2332329801315788138170227257306323
there2678329801313086138168219
is2920329801311856
a8503448013150
serious919344801314194125147204261300
risk124234480131295189134
of1396344801315886
inflammatory1505344801311976101128176264352400432487519570
complications20953448013148104192251274295343392423445502560599
which27133448013179137158206263
are850359801315183136
much10193598013191150199258
more13103598013192152184237
severe15723598013150104154207239292
if1889359801313261
the19743598013143103157
bulbar21563598013170129152212263296
segment24763598013150105166257311370403
is2904359801313272
involved.850374801312383131190214264318379399
If1274374801313261
a13603748013160
foreign1445374801313796129182205266325
body17953748013170131193243
remains2063374801314194185236258317358
in2446374801313291
the25623748013143103157
bulb,27443748013171130153214232
the850389801313491144
development10143898013159112160211234291351440492550581
of1615389801315886
an17213898013150107
abscess-forming18483898013150109148197247287326357385442474563584641700
process2568389801316092148197247287327
is2918389801311958
very8504048013150102133185
likely.105940480131274994146168216230
The13134048013155115168
video1505404801315477136189248
presents1781404801316092144184237295327369
the2174404801313896149
treatment2347404801313870121169202291344402434
and28054048013154112171
reconstruction850419801313284133189248287322354412460497519576635
of1510419801315987
the1621419801313593146
urethra1793419801315889141174232263313
following2130419801313087111132190269291349408
an25624198013151109
exten‑26964198013154101138189247280
sive850434801314161110161
abscess-forming10314348013149108147195245285324354383439470559581637696
process1746434801316192148196246286325
due20914348013159115167
to2282434801313085
an23864348013150107
underlying25134348013157114173225256278325348405463
foreign850449801312986118170191250308
body11794498013161120180228
(a1431449801312672
fish152444980131265392149
hook)16944498013159117176222252
inserted1970449801312077117170201238289349
into2343449801312078109165
the2532449801313189142
bulbar26954498013161119141200250281
urethra850464801315890141174232264313
by11884648013160107
the1319464801313493146
patient.14894648013160110143165217275307326
Case10004796013363117160215
presentation:1236479601336299154197252314349403439464525586608
The18664798013151111164
video2052479801315073133186245
presents2319479801316093145185239297330372
a27134798013149
case2784479801314999139193
of850494801315786
a9574948013149
75-year-old10274948013153101134182233281312341401424482
man15304948013189137194
who17454948013178136194
inserted1963494801311976115168199236287346
a23304948013149
fish240049480131265391148
hook25694948013158116174220
into2813494801311976108163
his850509801315982122
bulbar9975098013167126149209260293
urethra1315509801316497149183242275326
for1666509801313593126
the1817509801314099153
purpose19965098013166125158219280321375
of2396509801316494
masturba‑25215098013190140181217275308369420455
tion.850524801313560121183204
Initially,1081524801313395119155180231256280331346
he14545248013170127
was16175248013182135178
examined18215248013165116169262286347404468
repeatedly2315524801314498162219270305360423448499
for28415248013139100135
symptoms850539801314191183243277334425466
of1341539801316393
dysuria14635398013160110151209241265314
and18035398013154113174
treated2002539801313871124173206258320
by23525398013160109
his2486539801316386126
general26425398013160114173227260311334
practitioner850554801316091141189224246279301358416469500
for1374554801312581113
the1511554801313087140
diagnosis1671554801315981128187244302341362401
of2093554801315785
lower2202554801312077154206237
urinary2459554801315889111168216247299
tract2781554801313162111159195
infection.850569801312379107158207243265322380399
He12705698013168120
received1414569801312980129179201249301360
common17955698013148103192279337395
anti-inflammatory22105698013149106138160193216273298324372460547596628683715766
medications8505848013189142202224273322355377435493533
(cotrimoxazole,1407584801312671127159191214302361406456500557580633650
nitrofurantoin).2079584801315880114146202231289321371429461517539597622638
How‑27385848013169127205238
ever,8505998013153103156189203
he10785998013165119
denied12235998013165119178201255316
the15645998013140100154
presence17435998013167100152194248307357409
of2177599801316494
a22965998013156
foreign2377599801313593127179202262321
body.27235998013167127189238253
Fourteen8506148013151109169201240292347407
days12826148013169119167209
later,1516614801313383117169202216
he17586148013168122
presented19066148013170103156198252312345397459
with24006148013179103138197
exhaus‑26236148013162112171222280321353
tion850629801313457116176
and10516298013153112173
fever1249629801313285135188221
to1495629801313794
the1614629801313897151
emergency17906298013157147201234293347406456508
department23266298013160114175226258296387441500533
of2888629801315888
our8506448013159118150
hospital.10286448013159118159219243277328351371
Because14276448013155110160211269310364
of1819644801315888
scrotal1932644801314393126183217268291
and22486448013153111172
left2445644801312680109148
inguinal2618644801312684145203226285334358
swelling,8506598013142124179203227250311373393
orchiepididymitis12696598013169103152212236291353378439463525575669692728752793
was20986598013180133174
suspected.22996598013151110151213270321360413476497
For28226598013161120154
this850674801313493116156
reason,1031674801314193143183243302321
a13786748013158
urologist1461674801316699156181240301324364400
was18946748013179130171
called20906748013157108132154208270
by23856748013169117
the25276748013142101156
emer‑27086748013161151206238268
gency8506898013160114173223275
physician.11516898013161121168210232281304354413432
Since1609689801315275133183235
the1869689801313695149
local2043689801312584135186209
finding2277689801312855114174197256316
was26206898013180130171
sig‑2816689801314365126160
nificant,850704801315982109136186237296329349
the12257048013143102157
urologist14077048013168100158183242304327367403
ordered18357048013168101161215248300362
a22237048013159
CT23077048013172128
scan24607048013151101152211
of2696704801316898
the28197048013144103157
abdomen,8507198013150110172231321375434453
little132871980131214378115139192
pelvis,15437198013160115139189213253272
and18387198013150108169
genitalia.20297198013160114173195230280304326375395
The24477198013151112166
CT26357198013163118
scan2778719801313988139198
showed8507348013142102162244298361
an12377348013160121
extensive13847348013163113152205266307331382436
abscess-forming18467348013161123165216269312354387418477511604628688750
process26227348013171105164216270312354
in850749801312382
the957749801313493148
perineum,11307498013161116149172231285344434453
including1608749801312382132155213274296355416
a20497498013150
foreign2124749801313088121174197257316
body24657498013161121183232
(a2722749801313077
fish282474980131275494152
hook).8507648013160120181229261277
It1153764801313368
was12567648013180132174
only14557648013169129153203
the16847648013144104159
severity18697648013151106156210243268303356
of2251764801316899
his2375764801316993133
condition25347648013159117178239263298322382442
and3203898013150109169
the339889801313291145
clear356789801314972126175208
CT3798898013163119
evidence3940898013154103127188242301350402
that436789801313392142175
made4566898013190140200254
the484689801313291145
patient5015898013161112145168222281314
confess32031048013149105164192245286326
to3554104801313187
having36631048013159108156179237297
inserted3985104801312078118171203241292353
the4363104801313189143
foreign4530104801312684116168191250308
body.48601048013161120181230244
Sub‑51261048013151108168203
sequently,3203119801314195156214267326359382431445
a36701198013150
decision37421198013160114164187226249307366
was41311198013179129170
made43231198013190140200254
to4602119801313188
perform47121198013160115148180238271362
open50961198013159120174233
surgical32031348013142100133193217267319343
exploration35721348013163113175200260294346380403463524
with41311348013180105140200
abscess43571348013160122164214267309351
drainage47341348013170103155178238289350405
un‑51651348013169129164
der32031498013160114146
antibiotic33751498013150109142165225249308341364414
cover.38141498013149106156209241256
During40961498013171131163187245306
the4427149801313493148
procedure,4600149801316194152202254316374406459476
a51021498013150
fish517714980131275494152
hook32031648013159118178226
was34551648013180130171
removed3651164801313487177236286339400
endoscopically,40781648013153112172232273323380441465514565588611660674
and47771648013152110171
a49731648013151
partial50511648013161112144182205255278
reconstruction3203179801313388140200261304341375437488527551612674
of39041798013170100
the40311798013145106162
bulbar42201798013172133157220273307
urethra45531798013170104159194256289342
was49311798013182135177
per‑51351798013172129163194
formed3203194801312987120211266327
and35551948013155114175
perineal37551948013166121154177236290339363
urethrostomy4143194801316496149183242274332373409466556604
was47771948013180131171
created.4974194801315487139188222274335355
Urinary32032098013169101124183233265318
diversion3547209801316083133186219261283342401
was39742098013180130171
achieved41702098013151101160182236286339400
by45962098013161109
an47302098013151110
indwelling4865209801312482143223276299322345404464
20F32032248013154106158
urinary3383224801315991114173223255307
catheter3713224801314999133191245279331364
and40992248013150109169
vesicostomy.42902248013150103144166215272313348405496543557
The48702248013151112166
size5061224801313860105157
of5241224801315887
the3203239801313491144
indwelling3372239801312077136215267290312333391450
catheter3844239801314898130188241274325357
greater4222239801315991142190223274305
than4552239801313088137194
the4771239801313088141
usual4934239801315797153202224
16F51802398013153100149
was32032548013179130171
chosen33972548013150108168209263322
due37422548013160118172
to3940254801313289
concerns40522548013149106166216268300360401
about44762548013150111171230265
considerable47642548013149106166206229289343375426487511565
inflammatory3203269801312484112139191284377428463522557612
tissue3841269801314469110153213268
retraction4136269801314397133167220272310335396457
during46202698013171131165190250313
healing.49592698013170127178202226287349370
Next,32032848013170124173211231
the34592848013142101155
important36402848013131120181241274313363422455
phase41202848013169129179219274
of4419284801316696
nursing45402848013167125158200222281341
care49062848013157108141193
with51322848013180104138197
frequent3203299801312861112171227279336368
dressing3591299801315990141180220241298356
changes39682998013148105153210268320360
and43492998013148105164
irrigation453729980131195082104162211242264321379
followed.4940299801312581104125183260311370389
Betadine32033148013156110144195256279337392
solutions36203148013150109133192226249308368409
and40543148013159118178
silver-containing425731480131517396146199232262314371431464515538596619678738
agents50213148013159119173232265308
were32033298013181136170225
used34543298013169111167231
for3711329801313999134
irrigation.3871329801313367102126189240275299360421442
Concurrently,43403298013174133194246306340375429490524549599615
the49813298013144105161
pa‑51693298013172124160
tient3203344801313457111170203
took3431344801313289149197
antibiotics36513448013150109142165225249308341365414457
based41313448013161112153207268
on44233448013158118
sensitivity4566344801313993152193215250273323347382434
testing5025344801313285126161185243304
of3203359801315988
the33173598013143102157
collected34993598013159116140163217268306358420
inflammatory3944359801313291118145195285375426459516550603
abscess45723598013160121162212264306347
material.49533598013191141174227259283333356376
First,3203374801315173106148183203
134293748013153
g35053748013160
of3587374801315988
co-amoxiclav36983748013149106142191281341387411460483533581
was43023748013179130171
administered44963748013149110200223281304344380432464517578
intra‑5099374801312079112145196230
venously32033898013150104164224284325349399
which,36373898013180141164215274294
after3957389801315989128181215
one41973898013169129184
week,44173898013180134190237260
was47123898013181132174
switched49123898013151132157192240300355417
to3203404801313491
oral3319404801316497149172
form.3516404801313493126217237
The37784048013157118172
duration39754048013166124156207241264323382
of4382404801316494
targeted4501404801314090123182236270322383
antibiotic49104048013155114147170231254313347370419
therapy3203419801313596151185238300350
was35894198013181133175
1437914198013164113
days.39304198013171122171214236
For41924198013162121155
another43744198013160121182217277333367
1447674198013165114
days,49074198013171122171214235
the51684198013144105161
patient32034348013161112145168222281314
received3542434801313588138190213263316378
oral3948434801315891142165
cotrimoxazole41394348013151108142175198288348394445491548572626
al4791434801315275
forte4892434801313189122160213
with51324348013180103138197
a32034498013150
daily32824498013160110133156205
dosage35174498013159119160211272326
of3868449801316392
1-0-13985449801315887144181229
tablets.4239449801313889150174228262305325
In4589449801312887
three4701449801313897130182237
months,49684498013190149209242301341361
after3203464801315080119172205
the34334648013144103158
inflammatory3617464801313291119145196286377428462519553606
focus4249464801313897148207248
had45234648013169119180
been47294648013170126182241
healed,49964648013168123173197251313333
bulbar32034798013162123147209261295
urethral35244798013169102156192252286338363
reconstruction3913479801314296148207268310347381442493531555616677
was46264798013180133175
performed48274798013171128162196256290383439502
using32034948013160103126187250
the34804948013145107163
Johanson36704948013149111173225286329391453
technique.41494948013145100152214275299362422479498
Following46744948013162122148172234316341402465
the51664948013145107163
procedure,3203509801316195153204256318377409462481
the37095098013143103158
patient38925098013170122155179233293326
again42435098013160121171194253
received4522509801314295146198221272326388
a49355098013159
14-day50205098013163111147211261309
course32035248013149106165198240294
of3524524801315988
oral3640524801315891142166
cotrimoxazole38315248013151108141174198288347394445490548572626
al4482524801315276
forte4583524801313189122160212
with48235248013179103137196
a50455248013152
daily51245248013160110133156205
dosage32035398013160119160211272326
of3555539801315988
1-0-13670539801315381139176223
tablets.3919539801313585146170224259301322
Results:33535546013361119164226253290337360
Six3748554801315375124
weeks39095548013182136193240286
after4221554801316292132185218
the44655548013146106162
reconstruction4653554801314498150208269311347381442493531554615676
phase,32035698013161121171211265282
the35105698013142101155
indwelling3690569801313190150230283306328350409469
urinary4184569801316799122180230262315
catheter45235698013158109141200254288340372
and49195698013159118178
vesi‑51225698013158111152174207
costomy32035848013150107148184241332380
were36165848013181134166219
removed.3860584801314194185245294347409428
The43135848013161122176
indwelling4514584801313291152232285309331353412473
urinary50125848013168100123182232264317
catheter3203599801314999131190243276327359
was35945998013180129169
left3787599801313285113151
in3962599801313189
place4075599801316992141190241
longer4340599801313189148208261292
than46575998013142100149207
is4888599801313170
usual49825998013167106163212234
in5240599801313189
common32036148013148103190277334391
reconstructive3617614801312878126181238276309340397444479500548598
procedures4234614801316091146194244302358388438477
on47306148013158115
the4868614801312985137
urethra5024614801315888138170226256305
due32036298013159115167
to3393629801313085
some3497629801314098186238
concern37546298013149103161208258289346
about41206298013149108166222255
the4398629801313087139
success4556629801314196144189239278317
of4892629801315886
healing.49976298013158110157179200256314332
Typically,3203644801315090149171217266287308354366
an35886448013149105
indwelling3716644801311975132209260281302322378436
urinary4171644801315787109165212242292
catheter4482644801314897127184235267317347
is4852644801311856
left493164480131197097133
in5087644801311975
situ518064480131416193149
for3203659801312986118
three3345659801313795126178232
to3601659801313793
four3718659801313289147179
weeks.39246598013179131185231275294
Voiding42456598013156111133192214272331
cystourethrogra‑46006598013152103144178234292324375408466497554614645695729
phy32036748013160117162
revealed3388674801312879126177224245297356
a37636748013149
free3836674801312456106159
and40146748013149106164
healed41976748013158110157178230289
urethra.4505674801315888138170227257306325
The48496748013150109161
patient50296748013160109140161212269300
remained3203689801313386177227250309363425
under36536898013168127188242275
surveillance39526898013151109141195248271294316366425475527
care.45046898013159110142195213
Four47426898013160118177209
months49856898013191151211244304344
after3203704801315078115166198
the3425704801313593146
procedure,3597704801316092149198249309366398449466
the4087704801313593146
patient42597048013160110142165217275307
was45917048013180129169
satisfied4784704801314292125147186213239292352
and51617048013151109168
able32037198013150110133186
to3413719801313490
urinate3527719801315890112170219251302
freely,3853719801312962113167190237251
with41287198013179102135193
an43457198013150108
18F44777198013154100151
urethral4652719801315889141174232263313335
calibra‑5012719801314998121142202234284317
tion3203734801313456114172
and33987348013150108167
a35887348013150
peak36617348013160114162208
flow3892734801312653111189
rate4105734801313181113164
on42927348013159117
uroflowmetry4432734801315890146172199257335425478511543595
of5050734801315886
23.151597348013154107124170
mL/s.32037498013189136178213232
At3454749801316494
one-year35687498013157115167201248299346376
follow-up,3968749801312480103124181258290348406422
the4414749801312986138
patient45727498013160109140161213270301
continued48927498013149104161192213270326378437
to3203764801313489
be33127648013161114
symptom-free3446764801314190179238271326415449477510561614
and40807648013150107166
satisfied.4266764801314190122144183209236288348366
Urethral4652764801316999150183240271321343
calibra‑5015764801314898120141200231281314