Primary realignment of the disrupted prostatomembranous urethra. 1989

C J Devine, and G H Jordan, and P C Devine
Department of Urology, Eastern Virginia Medical School, Norfolk.

Urethral scarring resulting in stricture formation can be avoided or minimized by proper treatment after injury. On presentation of the trauma patient, the possibility of such injury must be suspected and the urethra evaluated prior to any attempts at catheter placement. Diversion in all cases of posterior urethral injury should be by a suprapubic tube, with any urinary extravasation drained at the site of the injury. If the patient's general condition allows it, the disrupted urethra should be realigned by a catheter after the puboprostatic ligaments have been divided. These measures allow the prostate to return to the urogenital diaphragm without tension and in line with the distal urethra. Until the prostate is released, no amount of traction will reapproximate the urethra, and after it is released, traction is not necessary. The suprapubic catheter provides diversion, preventing further complications caused by urinary extravasation; urethral alignment minimizes subsequent stricture formation. When the stricture develops, if it is urodynamically significant, it can be repaired in 4 to 6 months. If one is fortunate, the stricture will be short and amenable to internal urethrotomy. If not, open reconstruction will be greatly facilitated by the attempts to guide the distracted ends of the urethra together.

UI MeSH Term Description Entries
D007172 Erectile Dysfunction The inability in the male to have a PENILE ERECTION due to psychological or organ dysfunction. Impotence,Male Impotence,Male Sexual Impotence,Dysfunction, Erectile,Impotence, Male,Impotence, Male Sexual,Sexual Impotence, Male
D008297 Male Males
D008722 Methods A series of steps taken in order to conduct research. Techniques,Methodological Studies,Methodological Study,Procedures,Studies, Methodological,Study, Methodological,Method,Procedure,Technique
D010384 Pelvic Bones Bones that constitute each half of the pelvic girdle in VERTEBRATES, formed by fusion of the ILIUM; ISCHIUM; and PUBIC BONE. Coxal Bone,Hip Bone,Innominate Bones,Bone, Coxal,Bone, Hip,Bone, Innominate,Bone, Pelvic,Bones, Coxal,Bones, Hip,Bones, Innominate,Bones, Pelvic,Coxal Bones,Hip Bones,Innominate Bone,Pelvic Bone
D011859 Radiography Examination of any part of the body for diagnostic purposes by means of X-RAYS or GAMMA RAYS, recording the image on a sensitized surface (such as photographic film). Radiology, Diagnostic X-Ray,Roentgenography,X-Ray, Diagnostic,Diagnostic X-Ray,Diagnostic X-Ray Radiology,X-Ray Radiology, Diagnostic,Diagnostic X Ray,Diagnostic X Ray Radiology,Diagnostic X-Rays,Radiology, Diagnostic X Ray,X Ray Radiology, Diagnostic,X Ray, Diagnostic,X-Rays, Diagnostic
D005260 Female Females
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D014521 Urethra A tube that transports URINE from the URINARY BLADDER to the outside of the body in both the sexes. It also has a reproductive function in the male by providing a passage for SPERM. External Urethral Sphincter,External Urinary Sphincter,Internal Urethral Sphincter,Internal Urinary Sphincter,Internal Vesical Sphincter,Urethral Sphincters,External Urethral Sphincters,External Urinary Sphincters,Internal Urethral Sphincters,Internal Urinary Sphincters,Internal Vesical Sphincters,Sphincter, External Urethral,Sphincter, External Urinary,Sphincter, Internal Urethral,Sphincter, Internal Urinary,Sphincter, Internal Vesical,Sphincter, Urethral,Urethral Sphincter,Urethral Sphincter, External,Urethras,Urinary Sphincter, External,Urinary Sphincter, Internal,Vesical Sphincter, Internal
D014547 Urinary Diversion Temporary or permanent diversion of the flow of urine through the ureter away from the URINARY BLADDER in the presence of a bladder disease or after cystectomy. There is a variety of techniques: direct anastomosis of ureter and bowel, cutaneous ureterostomy, ileal, jejunal or colon conduit, ureterosigmoidostomy, etc. (From Campbell's Urology, 6th ed, p2654) Ileal Conduit,Conduit, Ileal,Conduits, Ileal,Diversion, Urinary,Diversions, Urinary,Ileal Conduits,Urinary Diversions
D050723 Fractures, Bone Breaks in bones. Bone Fractures,Broken Bones,Spiral Fractures,Torsion Fractures,Bone Fracture,Bone, Broken,Bones, Broken,Broken Bone,Fracture, Bone,Fracture, Spiral,Fracture, Torsion,Fractures, Spiral,Fractures, Torsion,Spiral Fracture,Torsion Fracture

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