title: Delayed repair of pelvic fracture urethral injuries: Preoperative decision-making.
abstract: Pelvic fracture urethral injuries comprise one of the most challenging reconstructive procedures in urology. The obliterated or stenosed urethra can usually be effectively repaired by an end-to-end anastomosis (bulbomembranous anastomosis). To achieve this, a progression of surgical steps can be used to make a tension-free anastomosis. Before undertaking surgery it is important to comprehensively assess the patient to define their anatomical defects, in particular the site of the stenosis, the length of the distraction injury and the integrity of the bladder neck, and thus guide preoperative decision-making. Contemporary reports suggest that most pelvic fracture urethral distraction defects (PFUDD) can be adequately managed by a perineal approach. Nevertheless it is essential that all surgeons treating these injuries are familiar with the whole spectrum of operative steps that are necessary to repair PFUDD.
authors.affiliation: Department of Urology, Royal Hallamshire Hospital, Sheffield, South Yorkshire, UK.
authors.forename: Nadir I
authors.initials: NI
authors.lastname: Osman
authors.affiliation: Department of Urology, Royal Hallamshire Hospital, Sheffield, South Yorkshire, UK.
authors.forename: Altaf
authors.initials: A
authors.lastname: Mangera
authors.affiliation: Department of Urology, Royal Hallamshire Hospital, Sheffield, South Yorkshire, UK.
authors.forename: Richard D
authors.initials: RD
authors.lastname: Inman
authors.affiliation: Department of Urology, Royal Hallamshire Hospital, Sheffield, South Yorkshire, UK.
authors.forename: Christopher R
authors.initials: CR
authors.lastname: Chapple
keywords: PFUDD, pelvic fracture urethral distraction defects; Pelvic fracture urethral injury; Preoperative decision making; Urethral distraction defect