The Journal of urology
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The Journal of urology · Jul 1998
Use of the perineal and perineal-abdominal (transpubic) approach for delayed management of pelvic fracture urethral obliterative strictures in children: long-term outcome.
The results of 2 surgical approaches to restore urethral continuity in children with pelvic fracture urethral obliterative strictures were retrospectively reviewed. ⋯ Children with urethral distraction injuries associated with pelvic fracture require perineal-transpubic exposure when urethral obliterations of 3 cm. or greater develop or local complications are present in the affected area, making it impossible to create a tension-free, spatulated epithelium-to-epithelium anastomosis to restore urethral continuity via the perineal route. This study also supports previous reports that suggest a relationship of urinary incontinence and associated bladder neck injury with severe pelvic fracture rather than with delayed urethral repair.