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Pelvic fracture with complete urethrovaginal complex avulsion
Keisha Y Dyer1, Charles W Nager
1From the University of California-San Diego, La Jolla, California.
Obstetrics and Gynecology
|July 29, 2010
Summary
A severe pelvic fracture can cause complete vaginal avulsion while sparing the urethra. This case highlights the strong connection between the urethra and anterior vaginal wall, crucial for understanding pelvic trauma.
Area of Science:
- Urology
- Anatomy
- Trauma Surgery
Background:
- The precise anatomical support of the female urethra remains a subject of debate.
- Pelvic fractures can lead to complex injuries affecting pelvic organs.
Observation:
- A case report details an 18-year-old female pedestrian involved in a motor vehicle accident.
- The patient sustained a pelvic fracture resulting in the avulsion of the intact vagina and urethra from the symphysis pubis.
Findings:
- Surgical reevaluation confirmed the urethra and vagina were avulsed from the symphysis pubis but remained intact.
- Successful surgical reapproximation of the avulsed structures to the periosteum and surrounding soft tissues was achieved.
- No urogenital sequelae were observed postoperatively.
Implications:
- Complete anterior vaginal wall avulsion can occur with preservation of the lower urinary tract following pelvic fractures.
- This case reinforces the anatomical understanding of a robust and dense attachment between the urethra and the anterior vaginal wall.
- The findings have implications for surgical management and understanding pelvic floor anatomy in trauma cases.
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