Traumatic avulsion of the lower urinary tract in the female child

Area of Science:

• Urology
• Pediatric Surgery
• Trauma Surgery

Background:

• Blunt pelvic injuries can cause severe genitourinary trauma.
• Complete avulsion of the proximal urethra from the bladder neck is a rare but devastating injury.
• Urethrovaginal fistulas secondary to trauma require complex surgical management.

Observation:

• A young girl sustained a complete avulsion of the proximal urethra from the bladder neck.
• A urethrovaginal fistula was identified as a secondary complication.
• The injury resulted from a blunt pelvic trauma.

Findings:

• A two-stage surgical approach was employed for management.
• The first stage involved a suprapubic cystostomy for urinary diversion.
• A subsequent transpubic repair of the urethral defect was performed 6 months later.

Implications:

• The described surgical technique successfully restored urinary continence in the patient.
• Postoperative follow-up confirmed the absence of urethral obstruction.
• This case highlights a viable management strategy for complex pediatric urethral injuries.