Experience With Management of Posterior Urethral Injury Associated With Pelvic Fracture

Abstract

Review of records from 205 patients with pelvic fracture and hematuria revealed that 121 underwent urologic and radiographic evaluation. Of these patients 20 had severe posterior urethral injuries documented by urethrography or voiding cystourethrograhy; 9 underwent primary repair and 11 had delayed scrotal-inlay urethroplasy after initial cystostomy alone. Patients who underwent primary repair had a 77% incidence of stricture, a 22% incidence of incontinence and a 33% incidence of impotency. Patients who underwent delayed closure had no incidence of stricture, incontinence or impotence. Patients in both groups had urinary tract infections. Simple cystostomy followed by delayed scrotal-inlay urethroplasty appears superior to primary realignment in the managment of patients with posterior urethral injuries.