Tehran University Medical Journal

Background: This study was conducted to evaluate results of urethroscopic management of iatrogenic urethral injuries due to gynecological operations.

Materials and Methods: From November 2001 till November 2003, 12 iatrogenic urethral injuries which were managed with mean time 12 hours (Range= 6-72) after gynecological operations were included in this study. 3 months after urethroscopy and distending, patients were evaluated with IVP. Mean time of clinical follow up was 12 months (range= 4-29).

Results: 7 patients with urethral stricture were found and considering fluoroscopy guided urethral dilatation with balloon in 2 of them, urethroscopy and distending was successful in 6 patients (85/7%). In 5 patients with complete dissection of urethra, urethroscopy and distending was successful only in 1 of them (20%). All patients were discharged after 24 hours and in follow up IVP after 3 months. Results were satisfactory in 6 of 7 patients. One of patients needed re-distending due to stricture.

Conclusion: Urethroscopic approach as first step in management of iatrogenic urethral injuries seems reasonable and cost benefit, specially in ligating lesions.

Background: Pneumothorax is a potential life-threatening condition especially in patients with underlying disorders. In this study we compared the diagnostic accuracy of general practitioners and emergency medicine specialists in interpreting chest x-rays (CXR) suspected of having iatrogenic pneumothorax in emergency departments.

Methods: This cross-sectional study was conducted in Shahid Chamran Hospital in Tehran, Iran during 2008- 2010. The study was designed to compare the ability of general practitioners and emergency medicine specialists in diagnosing iatrogenic pneumothorax regarding 500 CXRs of one-hundred patients admitted for upper central venous catheterization.

Results: General practitioners and emergency medicine specialists could accurately (P<0.001) diagnose pneumothorax in 484 (96.8%) and 497 (99.4%) CXRs, respectively. None of the underlying causes of the condition affected the diagnostic accuracy of both physician groups (P>0.05).

Conclusion: These findings indicate that the diagnostic accuracy of emergency medicine specialists is significantly higher than those of general physicians. The diagnostic accuracy of both physician groups was higher than the values in similar studies that signifies the role of relevant training given in the emergency departments of the Hospital.