Rupture of the female urethra in childhood

Rupture of the female urethra is a rare disorder, but perhaps more liable to occur in childhood than in adult life. As in the male, it can follow a fractured pelvis, but the level of the rupture is not simply in the membranous region, and is frequently much higher with destruction of the urethra over a considerable length. The vagina is always involved, so that almost inevitably there is a urethra-vaginal fistula. In the low lesions the bladder and urethral function may be adequate, but stenosis of the vaginal introitus can result in a considerable hydrocolpos, leading to a spurious form of incontinence. In the higher lesions true incontinence can occur, and there may be stricturing of the urethra above or below the urethro-vaginal fistula. Methods of surgical repair are discussed.