The nature of urethral injury in cases of pelvic fracture urethral trauma.
OBJECTIVE
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.


METHODS
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.


RESULTS
There was evidence of urethral sphincter function, including urodynamically in 11 (55%), endoscopically in 13 (65%) and functionally in 17 (85%) patients.


CONCLUSIONS
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.
Andrich
D E
DE
Institute of Urology and Nephrology, London, England.
Mundy
A R
AR
D000063:Accidents, Traffic; D000328:Adult; D050723:Fractures, Bone / Q000150:complications*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010384:Pelvic Bones / Q000293:injuries*; D011446:Prospective Studies; D014521:Urethra / Q000293:injuries* / Q000473:pathology / Q000503:physiopathology / Q000601:surgery; D014563:Urodynamics