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Pelvic fracture urethral distraction defects: Early outcome of progressive perineal repair

Purpose: Controversy still exists regarding timing and approach for pelvic fracture urethral distraction defects. We review our experience with 1-stage 4-step progressive perineal approach for urethral reconstruction. Materials and Methods: All patients presenting with urethral distraction injuries associated with pelvic fractures were initially assessed, stabilized and managed with suprapubic-catheter insertion. Progressive-perineal-urethral repair was performed at least 3- months following injury. Post-operative complications and early outcome was assessed in all these patients. Results: During the study period Jan 2010-Jan 2014, 26 male patients with a mean age of 34 years presented with pelvic fracture and posterior urethral distraction defects. Progressive-perineal repair was performed at least 3 months later. The repair needed spongiosal mobilisation alone in 10 cases, additional corporal separation in 13 and inferior pubectomy in 3 cases. 2 patients failed to void following urethral catheter removal and developed recurrent strictures at the repair site. 24 patients voided well after catheter removal and are voiding adequately at a mean follow up of 31 months Conclusion: Using the perineal approach and several manoeuvres, it is virtually possible to repair urethral distraction injuries through a perineal approach even with a long defect. Short term outcomes are good.



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Keywords: progressive perineal urethroplasty, pelvic fracture urethral distraction defect, reconstruction of urethra.

ISSN: 2454-9142

EISSN: 2454-9142

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