title: Con: bulbomembranous anastomotic urethroplasty for pelvic fracture urethral injuries.
abstract: Current literature remains controversial regarding whether to treat patients sustaining pelvic fracture urethral injuries (PFUIs) with primary endoscopic realignment (PER) versus suprapubic tube (SPT) placement alone with elective bulbomembranous anastomotic urethroplasty (BMAU). Success rates for PER following PFUI are wide-ranging, depending on various authors' definitions of what defines a successful outcome. At our institution, for SPT/BMAU patients, the mean time to definitive resolution of stenosis was dramatically shorter compared to PER cases. The vast majority of PER patients required multiple endoscopic urethral interventions and/or experienced various other adverse events which were rarely noted among the SPT/BMAU group. While PER does occasionally result in urethral patency without the need for further intervention, the risk of delay in definitive treatment and potential for adverse events has led to a preference for SPT and elective BMAU at our institution.
authors.affiliation: Department of Urology, UT Southwestern Medical Center, Dallas, TX 75390-9110, USA.
authors.forename: Timothy J
authors.initials: TJ
authors.lastname: Tausch
authors.affiliation: Department of Urology, UT Southwestern Medical Center, Dallas, TX 75390-9110, USA.
authors.forename: Allen F
authors.initials: AF
authors.lastname: Morey
keywords: Pelvic fracture urethral injury (PFUI); urethral stricture; urethroplasty
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