The type of urethroplasty for a pelvic fracture urethral distraction defect cannot be predicted preoperatively
D E Andrich1, K J O'Malley, D J Summerton
1Institute of Urology, London, United Kingdom.
Purpose:
Pelvic fracture urethral distraction defects (PFUDDs) are generally treated surgically by a so-called progression approach consisting of 4 steps to achieve a tension-free bulboprostatic anastomosis. Implicitly the need for each step in turn is predictable according to the length of the defect on preoperative x-ray.
Materials And Methods:
In 62 evaluable patients with PFUDD the length of the radiological defect was compared with the surgical steps that subsequently proved necessary to achieve a tension-free bulboprostatic anastomosis.
Results:
Except at the extremes of length there was no association between defect length and the scale of the surgery performed.
Conclusions:
Surgeons preparing to repair an apparently short PFUDD cannot assume that simple repair is all that is necessary.
