[Recent urethral rupture. From diagnosis to treatment]

A retrospective study of 30 cases of rupture of the urethra treated over a period of 12 years showed that the membranous urethra was involved in 25 patients. Cases of partial rupture of the anterior urethra treated by transient urine bypass were excluded from the study. As a result of the only moderate results obtained before 1977, the following therapy was instituted for ruptures of the posterior urethra after that date: immediate insertion of a suprapubic bladder drain (percutaneous or surgical); visualization of bladder and urethra on the 5th day using the bladder catheter and retrograde urethrography; deferred emergency repair operation towards the 8th or 10th day for cases with a stable pelvis and absent vital lesions; delayed repair during the 3rd month for the other cases. Results were evaluated as good with respect to urethral permeability in 3 of the 6 cases of emergency repair, 10 of 12 patients receiving deferred emergency surgery and 11 of 12 cases of delayed operation. Only two cases of sexual impotency were noted among the last ten cases treated. The obvious procedure to be adopted whenever possible is therefore an end-to-end urethrography as a deferred emergency operation.