[Urological relevance of pelvic fractures]

1. Apparently it is the anatomical difference of the paravesical structures which determines, whether a pelvic fracture will result in urological complications or not. The more the urogenital diaphragm is involved, the less is the risk of urological complications. The type of pelvic fracture and the magnitude of the trauma are of minor importance. 2. With respect to pathology and typology, one has to differentiate between incomplete and complete disruption of the urethra. The more pronounced the rupture is, the more the distal stump will retract back into the injured urogenital diaphragm. The longitudinal rupture splits the anterior wall of the urinary bladder and prostate; the rupture may extend into the membranaceous urethra. 3. Bleeding from the urethral meatus and the endogenous cystogram yield the most to the diagnosis of urological complications of a pelvic fracture. 4. The therapy is twofold. In the case of complete urethral disruption and dehiscence of the bony fragments, operative transvesical atraumatic splinting of the urethra by means of a Foley catheter is indicated. In the case of incomplete urethral rupture, transurethral insertion of a Foley catheter is usually sufficient and successful. 5. The results of the various therapeutical approaches equal the original extent of the urological complication. In addition to a certain degree of posttraumatic urethral stricturing, there are five further well defined sequelae of late urethral injuries.