Advertisement

World Journal of Urology

, Volume 5, Issue 1, pp 30–36 | Cite as

Repair of the difficult posterior urethral stricture

  • George D. Webster
Article

Summary

Fewer than 10% of strictures which follow pelvic fracture will be complex, the vast majority being amenable to simple perineal anastomotic repair. The complex strictures are best managed in a center experienced in their care and a variety of maneuvers are used for their correction. One-stage anastomotic repairs are still optimal and are applicable to most cases, however, the surgeon must be prepared to elaborate the procedure depending on the intraoperative findings. Substitution urethroplasties (one- or two-stage vascularized flaps) are reserved for salvage in cases in which associated anterior urethral pathology or long urethral defects preclude an anastomotic procedure. Erectile dysfunction and incontinence which may accompany more severe injuries are now manageable by prosthetic and other techniques.

Keywords

Public Health Erectile Dysfunction Severe Injury Pelvic Fracture Urethral Stricture 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. 1.
    Pokorny M, Portes JE, Pierce JM (1979) Urologic injuries associated with pelvic trauma. J Urol 121:1455Google Scholar
  2. 2.
    Huittenen VM, Slatis P (1972) Fractures of the pelvis. Acta Chir Scand 138:563Google Scholar
  3. 3.
    Webster GD, Mathes GL, Selli C (1985) Prostatomembranous urethral injuries: A review of the literature and a rational approach to their management. J Urol 130:898Google Scholar
  4. 4.
    Turner-Warwick R (1977) Complex traumatic posterior urethral strictures. J Urol 118:564Google Scholar
  5. 5.
    Raffa J, Christensen NM (1976) Compound fractures of the pelvis. Am J Surg 132:282Google Scholar
  6. 6.
    Webster GD, Koefoot RB, Sihelnik SA (1985) The management of strictures of the membranous urethra. J Urol 134:469Google Scholar
  7. 7.
    Webster GD, Goldwasser BZ (1986) Perineal transpublic repair: A technique for treating post traumatic prostatomembranous urethral strictures. J Urol 135:278Google Scholar
  8. 8.
    Waterhouse K, Lawngani G, Patel U (1980) The surgical repair of membranous urethral strictures: Experience with 105 consecutive cases. J Urol 123:500Google Scholar
  9. 9.
    Turner-Warwick RT (1983) Urethral stricture surgery. In: Glenn JF (Ed) Urologic Surgery, JB Lippincott, Philadelphia, 3rd Ed. p 689–719, Chapt 68Google Scholar
  10. 10.
    Webster GD, Robert SN (1985) The vascularized skin island urethroplasty: Its role and results in urethral structure management. J Urol 133:31Google Scholar
  11. 11.
    Moorehouse DD, MacKinnen KJ (1980) Management of prostatomembranous urethral disruption: 13 years experience. J Urol 123:173Google Scholar
  12. 12.
    Blandy JP, Singh M (1975) The technique and results of one-stage island patch urethroplasty. Brit J Urol 47:83Google Scholar

Copyright information

© Springer-Verlag 1987

Authors and Affiliations

  • George D. Webster
    • 1
  1. 1.Department of Urology — 198Duke University Medical CenterDurhamUSA

Personalised recommendations