Patterns of urethral injury and immediate management.
OBJECTIVE
The management of urethral trauma remains controversial. The purpose of this review is to provide a concise account of the patterns of urethral injury and the current trends of its immediate management.


RESULTS
Recent studies have identified types of pelvic fractures associated with a higher risk of urethral injury. Recognition of these fractures coupled with timely radiographic imaging has facilitated the earlier diagnosis of urethral injury and ensured that serious long-term sequelae are minimized. In highly selected cases of complete anterior and posterior urethral disruption primary realignment by a combined antegrade and retrograde endoscopic approach is increasingly being considered as a management option to restore early urethral continuity. Urethral trauma secondary to penetrating gunshot wounds and penile fracture requires immediate surgical exploration and repair.


CONCLUSIONS
The urologist involved in the management of genitourinary tract trauma needs to recognize the patterns of urethral injury, especially those associated with certain pelvic fractures. A judicious and systematic approach coupled with a conscious effort to minimize short and long-term sequelae of all urethral injuries will ensure optimal results. There is a need for a consensus on the optimal management of each of the vast arrays of urethral injuries.
Kommu
Sashi S
SS
Derriford Hospital, Plymouth, Devon, UK.
Illahi
Ihsan
I
Mumtaz
Faiz
F
D000063:Accidents, Traffic; D002944:Circumcision, Male / Q000009:adverse effects; D053715:Cystotomy; D004724:Endoscopy; D005260:Female; D050723:Fractures, Bone / Q000150:complications; D013509:Gynecologic Surgical Procedures / Q000009:adverse effects; D006801:Humans; D007049:Iatrogenic Disease; D008297:Male; D013513:Obstetric Surgical Procedures / Q000009:adverse effects; D010388:Pelvis / Q000293:injuries; D011859:Radiography; D012307:Risk Factors; D016896:Treatment Outcome; D014521:Urethra / Q000000981:diagnostic imaging / Q000293:injuries* / Q000601:surgery; D013520:Urologic Surgical Procedures / Q000009:adverse effects / Q000379:methods; D014947:Wounds and Injuries / Q000000981:diagnostic imaging / Q000209:etiology / Q000601:surgery*; D014948:Wounds, Gunshot / Q000601:surgery