title: Pelvic fracture-associated urethral injuries in girls: experience with primary repair.
abstract: OBJECTIVE
  To present our experience with four urethral injuries in females accompanying a pelvic fracture, managed with primary repair or realignment of the urethra.
  
  
  METHODS
  There were three teenage girls and one adult (22 years old). All the patients had complete urethral injuries associated with a pelvic fracture from accidents. They were managed by immediate suprapubic cystostomy followed by repair or realignment of the urethra over a catheter on the same day. The catheter was removed after 3 weeks and a voiding cysto-urethrogram taken. Thereafter they were followed with regular urethral calibration.
  
  
  RESULTS
  All patients voided satisfactorily with a good stream; three were fully continent and the fourth had transient stress urinary incontinence. One patient needed dilatation at 2 months and another visual internal urethrotomy at 5 months. At a mean (range) follow-up of 33 (9-60) months all the patients had a normal voiding pattern and were continent; none developed vaginal stenosis.
  
  
  CONCLUSIONS
  Primary repair of the urethra, and if that is impossible, simple urethral realignment over a catheter, is the procedure of choice for managing female urethral injury associated with a pelvic fracture. The procedure has the additional advantage of reducing the risk of vaginal stenosis.
authors.affiliation: Department of Urology, Jawaharlal Institute of Postgraduate Medical Education and Research, Pondicherry, India. gowidorai@sify.com
authors.forename: Lalgudi N
authors.initials: LN
authors.lastname: Dorairajan
authors.forename: Harendra
authors.initials: H
authors.lastname: Gupta
authors.forename: Santosh
authors.initials: S
authors.lastname: Kumar
mesh_terms: D000293:Adolescent; D000328:Adult; D005260:Female; D050723:Fractures, Bone / Q000150:complications*; D006801:Humans; D010384:Pelvic Bones / Q000293:injuries*; D014521:Urethra / Q000293:injuries* / Q000601:surgery; D014621:Vagina / Q000293:injuries