title: Urethral pull-through operation for the management of pelvic fracture urethral distraction defects.
abstract: OBJECTIVE
  To present our institutional experience in the management of pelvic fracture urethral distraction defects with urethral pull-through operation.
  
  
  METHODS
  Seventy-six patients (average age 34.5 years) with posterior urethral strictures caused by pelvic fracture urethral distraction defects underwent urethral pull-through operation at our department from July 1995 to September 2009. The estimated urethral stricture length was 2.0-3.5 cm (mean 2.5). Of these patients, 31 (41%) had undergone failed urethroplasty or urethrotomy after the initial management, and 5 (7%) had urethrorectal fistula. Urethral pull-through operation was performed 4-7 months (mean 4.9) after initial treatment or failed urethral reconstruction. The clinical outcome was considered a failure when any postoperative intervention was needed.
  
  
  RESULTS
  Follow-up was 14-74 months (mean 42.5). The overall success rate was 89% (68/76). All treatment failures occurred within the first 6 months postoperatively. Failed repairs were successfully managed with internal urethrotomy in 1 patient, by urethral dilation in 6, and by another urethroplasty in 1. All patients were urinary-continent postoperatively. Of the potent patients, 2 (5%) became impotent after urethroplasty. There was no chordee, penile shortening, or urethral fistula recurrence.
  
  
  CONCLUSIONS
  Urethral pull-through operation might be a less demanding and less time-consuming procedure. It does not increase the rate of impotence or incontinence and, with a high success rate, might serve as an alternative method for the management of pelvic fracture urethral distraction defects.
authors.affiliation: Department of Urology, China Medical University, Shenyang, China.
authors.forename: Lei
authors.initials: L
authors.lastname: Yin
authors.forename: Zhenhua
authors.initials: Z
authors.lastname: Li
authors.forename: Chuize
authors.initials: C
authors.lastname: Kong
authors.forename: Xiuyue
authors.initials: X
authors.lastname: Yu
authors.forename: Yuyan
authors.initials: Y
authors.lastname: Zhu
authors.forename: Yuxi
authors.initials: Y
authors.lastname: Zhang
authors.forename: Yuanjun
authors.initials: Y
authors.lastname: Jiang
mesh_terms: D000293:Adolescent; D000328:Adult; D005500:Follow-Up Studies; D050723:Fractures, Bone / Q000473:pathology; D006801:Humans; D008297:Male; D008875:Middle Aged; D008953:Models, Anatomic; D010388:Pelvis / Q000473:pathology; D012189:Retrospective Studies; D013997:Time Factors; D016896:Treatment Outcome; D014521:Urethra / Q000601:surgery*; D014525:Urethral Stricture / Q000601:surgery*; D014549:Urinary Incontinence / Q000601:surgery*; D013521:Urologic Surgical Procedures, Male / Q000379:methods*