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Posterior Urethral Strictures.

Joel Gelman1, Eric S Wisenbaugh1

  • 1University of California, Irvine, 333 City Boulevard West, Suite 1240, Orange, CA 92868, USA.

Advances in Urology
|December 23, 2015
PubMed
Summary

Pelvic fracture urethral injuries often cause disruptions requiring suprapubic tube placement. Delayed reconstruction with excision and primary anastomosis is the standard for strictures following initial management.

Area of Science:

  • Urology
  • Trauma Surgery
  • Reconstructive Surgery

Background:

  • Pelvic fracture urethral injuries involve disruptions of the proximal bulbar and distal membranous urethra.
  • Emergency management typically includes suprapubic tube (SPT) placement.
  • Primary realignment with urethral catheterization post-SPT is controversial.

Purpose of the Study:

  • To review the management of pelvic fracture urethral injuries.
  • To discuss preoperative urethral imaging techniques.
  • To outline posterior urethroplasty for stricture management.

Main Methods:

  • Review of patient management strategies for pelvic fracture urethral injuries.
  • Discussion of diagnostic imaging for urethral strictures.
  • Description of surgical techniques for posterior urethroplasty.

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Main Results:

  • Strictures, often obliterative with distraction defects, commonly develop after SPT placement or catheter removal.
  • Delayed urethral reconstruction via excision and primary anastomosis is the established standard of care for strictures.
  • Preoperative imaging and surgical reconstruction are key components of management.

Conclusions:

  • Management of pelvic fracture urethral injuries requires careful consideration of initial stabilization and delayed reconstruction.
  • Posterior urethroplasty is the definitive treatment for post-traumatic urethral strictures.
  • Standardized approaches to imaging and surgical repair improve outcomes.