Primaryb realignment of Traumatic posterior urethral rupture.

Abstract

Background: Posterior urethral rupture remains
one of the most difficult and controversial injuries
to treat and its management still controversial.
Aim: To assess the effect of primary
realignment of posterior urethral rupture.
Methods: in this study, 20 patients (mean age
24.7 years, range 12 to 39 years) were admitted to
al-kindey teaching hospital, Baghdad, Iraq, with
complete posterior urethral rupture associated with
fractured pelvis following trauma (3 cases of fall
from high, 17 cases of road traffic accidents). All
the patients were operated upon at the day of
accident to establish the alignment of the posterior
urethra on a Foley's catheter with bladder drainage
by suprapubic catheter. Patients were evaluated
post-operatively for urinary incontinence, erectile
dysfunction, and urethral stricture. They were
followed up for a mean period of 17 months
(range, 10 to 20 months).
Results: posterior urethral rupture was
associated with pelvic fractures in 18 of 20
patients (90%), and only one case had bladder
rupture (5%). Seven patients (35%) had evidence
of post operative stricture. Erectile dysfunction
was reported by 2 patients (10%). none of the
patients had urinary incontinence.
Conclusion: Primary realignment of PUR is a
simple procedure associated with low morbidity. It
is recommended for patients who are stable and
have no other significant intra-abdominal and
pelvic organ injuries.