title: SIU/ICUD Consultation on Urethral Strictures: Pelvic fracture urethral injuries.
abstract: The posterior urethra pierces the perineal diaphragm in close relationship to the pubic arc elements of the bony pelvis to which it is tethered by attachments to the puboprostatic ligaments and the perineal membrane. Because of these relationships, it is not surprising that fracture disruptions of the pelvic ring can be associated with injuries to the urethra at this level. Although the relationship between pelvic fracture and posterior urethral injury has been recognized for >1 century, considerable controversy exists on almost any aspect of these injuries, from the anatomy and classification of the injuries to the strategies for acute management, reconstruction, and treatment of complications, to mention just a few. What it is not controversial and well known is that these injuries can result in significant morbidity in the long run--mainly strictures, erectile dysfunction, and urinary incontinence--which can cause lifelong disability. It also well known that, just as in many other areas of trauma, the severity and duration of the complications can be reduced considerably if the injury is diagnosed and treated promptly and efficiently. This chapter summarizes the most relevant published evidence about the management of pelvic fracture urethral injuries. This comprehensive review, performed by an international panel of experts, will provide valuable information and recommendations to help urologists worldwide improve the treatment and outcomes of their injured patients.
authors.affiliation: Hospital del Trabajador, Santiago, Chile. Electronic address: rgomez@manquehue.net.
authors.forename: Reynaldo G
authors.initials: RG
authors.lastname: Gómez
authors.affiliation: University College London Hospitals NHS Foundation Trust, London, UK.
authors.forename: Tony
authors.initials: T
authors.lastname: Mundy
authors.affiliation: Manipal Institute of Urology and Nephrology, Manipal Hospital, Bangalore, India.
authors.forename: Deepak
authors.initials: D
authors.lastname: Dubey
authors.affiliation: Ain Shams University, Cairo, Egypt.
authors.forename: Abdel Wahab
authors.initials: AW
authors.lastname: El-Kassaby
authors.affiliation: School of Medicine, University of Indonesia, Jakarta, Indonesia.
authors.lastname: Firdaoessaleh
authors.affiliation: Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada.
authors.forename: Ron
authors.initials: R
authors.lastname: Kodama
authors.affiliation: Detroit Medical Center, Detroit, MI.
authors.forename: Richard
authors.initials: R
authors.lastname: Santucci
mesh_terms: D032921:Consensus; D004724:Endoscopy / Q000379:methods; D007172:Erectile Dysfunction / Q000209:etiology; D050723:Fractures, Bone / Q000150:complications* / Q000175:diagnosis; D006801:Humans; D008297:Male; D010384:Pelvic Bones / Q000293:injuries*; D012003:Rectal Fistula / Q000601:surgery; D014521:Urethra / Q000293:injuries* / Q000601:surgery; D014522:Urethral Diseases / Q000601:surgery; D014525:Urethral Stricture / Q000209:etiology* / Q000601:surgery; D014548:Urinary Fistula / Q000601:surgery; D014549:Urinary Incontinence / Q000209:etiology; D013521:Urologic Surgical Procedures, Male / Q000379:methods