title: Traumatic absence of the proximal urethra.
abstract: OBJECTIVE
  Traumatic absence of the proximal urethra is an obstetrical vesicovaginal fistula resulting from obstructed labors in Niger, Africa. Repair by direct reanastomosis was evaluated.
  
  
  METHODS
  A prospective case series of 25 women with traumatic absence of the proximal urethra underwent a direct layered reanastomosis of the distal urethra to the urethrovesical junction. Results are based on 21 patients (84%) examined at follow-up.
  
  
  RESULTS
  Seventeen patients (81%) had complete healing of their fistulas. After direct reanastomosis alone, 48% (10 of 21) were dry. An additional 7 patients (33%) suffered from urinary incontinence despite closure of their fistulas. Four patients (19%) had a persistent fistula.
  
  
  CONCLUSIONS
  Direct layered reanastomosis is an acceptable primary repair procedure for traumatic absence of the proximal urethras.
authors.affiliation: Mercy Medical Center, Baltimore, MD 21202, USA. mroenneburg@mdmercy.com
authors.forename: Marcella L
authors.initials: ML
authors.lastname: Roenneburg
authors.forename: Clifford R
authors.initials: CR
authors.lastname: Wheeless
mesh_terms: D000293:Adolescent; D000328:Adult; D000714:Anastomosis, Surgical / Q000379:methods; D005260:Female; D006801:Humans; D009336:Necrosis; D007744:Obstetric Labor Complications; D011247:Pregnancy; D011446:Prospective Studies; D014521:Urethra / Q000293:injuries* / Q000473:pathology / Q000601:surgery; D001743:Urinary Bladder / Q000601:surgery; D014549:Urinary Incontinence / Q000209:etiology; D014719:Vesicovaginal Fistula / Q000150:complications / Q000601:surgery*