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THE NATURE OF URETHRAL INJURY IN CASES OF PELVIC FRACTURE URETHRAL TRAUMA

2001; Lippincott Williams & Wilkins; Volume: 165; Issue: 5 Linguagem: Inglês

10.1016/s0022-5347(05)66334-3

1527-3792

Daniela E. Andrich, Anthony R. Mundy,

Hernia repair and management

We examine the urethral injury associated with pelvic fracture that is said to be due to a shearing force through the membranous urethra which inevitably destroys the urethral sphincter mechanism.A total of 20 asymptomatic cases were prospectively studied, including symptomatically, radiologically, endoscopically and urodynamically, 1 to 4 years after an apparently successful anastomotic repair of a pelvic fracture urethral distraction defect.There was evidence of urethral sphincter function, including urodynamically in 11 (55%), endoscopically in 13 (65%) and functionally in 17 (85%) patients.These findings, coupled with surgical observation, suggest that the urethral injury associated with pelvic fracture is avulsion of the membranous urethra from the bulbar urethra rather than a shearing through the membranous urethra, and that some degree of urethral sphincter function is preserved in a significant percentage of patients.