The aim of this study was to investigate and present long term follow‐up results of primary endoscopic realignment in patients with traumatic urethral rupture.

We reviewed our electronic records between 2010 and 2015. Data were collected retrospectively in patients undergone primary endoscopic realignment after urethral trauma. Age, trauma localization, presence of complete or incomplete defect, foley cathaterization period, postoperative urinary flow rate, erectile function score and the need for a secondary surgery were recorded.
Technically firs we did uretroscopy with flexible cystoscope and see perforated urethra and search other part of avulsed proximal part when we located proximal part advancement cystoscope and enter the bladder visually with got throuht prostatic urethra. if it was not be able to find primal part of mmebranous urethra ascending technique was used. In ascending technique flexible cystoscope  was introduced throught suprapubic cystotomy tract or with using amplatz sheath. after enter the bladder cystoscope advencement through prostatic urethra , in same time foley catheter was inserted from external meatus and keep it, when tip of foley catheter was seen with cystoscope foley catheter was pulling slowly and cystoscope advancement to catheter. After access was done hydrophilic guide wire was inserted and  cystoscope was removed. Foley catheter was inserted over guide wire to bladder.

The mean age of patients was calculated as 43,6 ± 21,5. Four of five patients had complete urethral rupture, one patients had incomplete rupture. All of patients defects localized in membranous urethra. We performed primary endoscopic urethral realignment in two, two and one at first, second and fifth day respectively. One patient undergone realignment combine ascending descending technique. Only ascending technique was performed in four patients.

We catheterized patients with 18 Fr foley catheter, and intermittent traction was performed in all patients. The mean catheterization time was 4,4 ± 0,8 weeks. The mean follow‐up period was 27,6 ± 24,5 months ( 3 ‐ 60 month ). First month visit of patients after foley catheter removal, mean urinary flow rate was calculated as 21 ± 15,8 ml/sn . Erection is found normal which 2 patient in sixth month, 2 patient in first month ( IIEF: 27,6 ± 0,5 ). None of them have a need of secondary surgery due to recurrent structure.

Despite we have limited number of patients, we can conclude that endoscopic realignment is an effective treatment modality in patients with urethral rupture. None of our patients have need to secondary surgery.