[Perineal wound with urethral lesion in man. Two cases]

The author reports two cases of perineal wounds with section of the membranous urethra, one operated upon as a delayed emergency (36 hours) and the other as an emergency via a double hypogastric and perineal approach which permitted the opening of the bladder, anterograde catheterisation of the posterior urethra, liberation of the ends of the urethra and their preparation, mobilisation of the anterior urethra and finally end-to-end suture. Both patients seen with a follow-up of 6 months and one year had an excellent mictional result and preservation of erection. The author emphasises the following: --the need for confirming integrity of the bladder by I.V.U.; --the possibility of operating as a delayed emergency after packing of the wound, under cover of bladder drainage via a suprapubic catheter; --the need for a double hypogastric and perineal approach for lesions of the posterior urethra; --the usefulness of urethral catheter for 5 days and drainage of the urine by cystostomy for 3 to 4 weeks. Neither of the patients required secondary dilatation (at least within the limits of the period of postoperative follow-up).