title: Repair of pelvic fracture posterior urethral defects using an elaborated perineal approach: experience with 74 cases.
abstract: A total of 74 patients with posterior urethral distraction defects (1.5 to 7 cm. long) that followed pelvic fracture was managed by a 1-stage perineal repair. End-to-end anastomosis was performed in all cases but in 66 a variety of surgical maneuvers were necessary to accomplish a tension-free anastomosis. These techniques, which included distal urethral mobilization, corporeal body separation, inferior pubectomy and supracrural urethral rerouting, were resorted to in a sequential manner as needed. Excellent results were achieved in 96% of the cases. These surgical techniques are described and discussed.
authors.affiliation: Division of Urologic Surgery, Duke University Medical Center, Durham, North Carolina 27710.
authors.forename: G D
authors.initials: GD
authors.lastname: Webster
authors.forename: J
authors.initials: J
authors.lastname: Ramon
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000714:Anastomosis, Surgical / Q000379:methods; D002648:Child; D050723:Fractures, Bone / Q000150:complications*; D006801:Humans; D008297:Male; D008722:Methods; D008875:Middle Aged; D010384:Pelvic Bones / Q000293:injuries*; D010502:Perineum / Q000601:surgery; D011183:Postoperative Complications; D011859:Radiography; D014521:Urethra / Q000000981:diagnostic imaging / Q000293:injuries* / Q000601:surgery; D014525:Urethral Stricture / Q000000981:diagnostic imaging / Q000209:etiology; D014947:Wounds and Injuries / Q000601:surgery