Retreat from transpubic urethroplasty for obliterated membranous urethral strictures.
A direct vision urethrotome was used to incise the perineal membrane and join the proximal bulbous urethra to the dorsal prostate in 4 men with totally obliterated posterior urethras following pelvic fractures. All 4 patients have maintained patent urethras for 2 to 9 months. Progressive dilation has not been required in 3 men. A repeat internal urethrotomy was necessary in 1 patient who currently requires urethral sounding every 6 weeks. A comparison with 8 previous transpubic urethroplasties for the same surgical problem revealed a significant decrease in blood loss and hospital stay with direct vision urethrotomy. Transurethral incision of the obliterated posterior urethra following a crushing injury to the pelvis may be a reasonable initial procedure for restoring urethral continuity prior to more extensive urethroplasty.
D000328:Adult; D050723:Fractures, Bone / Q000150:complications; D006801:Humans; D008297:Male; D008722:Methods; D008875:Middle Aged; D010384:Pelvic Bones / Q000293:injuries; D014521:Urethra / Q000293:injuries / Q000601:surgery*; D014525:Urethral Stricture / Q000601:surgery*