MOSTAFA A.
SALAR GAAFAR
From the Department of Urology, Faculty of Medicine, University of Alexandria, Alexandria, Egypt
ABSTRACT
Bulboprostatic anastomotic urethroplasty was +r... strictures secondary to pelvic fractures. The ~-n.lrYrr,\~("1· abdominoperineal in 16, with good children the urethral disruption branous junction. In such cases the repair of the injury is advisable. In the case of common prostatomembranous significant. In such cases a transpubic approach is is deranged, it can be managed at the same time. ..,-,.A·...
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KEY WORDS:
urethral stricture, pelvic bones, pediatrics
Posterior urethral stricture after bony pelvic fracture and complete disruption of the prostatomembranous urethra is a misnomer, being neither urethral nor a stricture. It is either a fistulous or fibrous tract between the displaced prostate above and the bulbous urethra below the lesion.! posttraumatic urethral strictures in children have features warrant consideration the mEln2lge:me:nt. present our experience in the management of Ch].1dJ~en post-traumatic posterior urethral strictures. MATERIAL AND METHODS
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anastomosis 'rv'·''''' tomotic line was away from the rectum. Patients were followed flowmetry for 1 to 7 years. assessed as Lt~rJ L
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Between 1978 and 1985, 20 patients with suprapubic tubes indwelling were referred to us because of posterior urethral strictures secondary to bony pelvic fractures. Of the pwtleltlts 18 were 2 to 12 years old and 2 were 18 years old (the latter 2 had sustained the urethral were included because injury during childhood). The level of the was at prostatomembranous junction in 17 and across the prostate itself in 3 (fig. In 2 of the 20 patients had associated rectal injury that resulted in a rectourethral fistula and they were referred to us with a transverse COJlostolny addition a cystostomy Besides the routine and ... -o""' ..... "" urE~th.rOI;rra,ph.y assess the extent of obliterated fibrous tract as evaluate competency nism. Anastomotic months after the several years later. A was used in in whom the prostate was accessible and a combined tr2lnSDulblC a h,rln.1VY\1"nn.·n011"1Yloa I anastomotic was in 15 whom the prostate was markedly displaced One patient had complete obliteration of the entire length of the prostatic urethra; the urethral defect was by a distally based anterior bladder tube (fig. 2). The transpubic approach adopted in our series was essentially that of Waterhouse et al. 2 Dissection lateral and posterior to the prostate was avoided unless there was an associated rectourethral fistula. In addition, pubectomy was followed by cauterization of the bone edges to prevent new bone formation. The mucosa of the prostatic urethra was everted and pinned to the edges of the prostate gland to prevent its recession and to be sure that the anastomosis was actually mucosa-to-mucosa. .n"{7c,-rn.,n"1l"eratlve, and postoperhT
'-'!J'V.L ....
SALAR GAAFAR
From the Department of Urology, Faculty of Medicine, University of Alexandria, Alexandria, Egypt
ABSTRACT
Bulboprostatic anastomotic urethroplasty was +r... strictures secondary to pelvic fractures. The ~-n.lrYrr,\~("1· abdominoperineal in 16, with good children the urethral disruption branous junction. In such cases the repair of the injury is advisable. In the case of common prostatomembranous significant. In such cases a transpubic approach is is deranged, it can be managed at the same time. ..,-,.A·...
.".'VV\Ar.l
h
1tJ'V' .Ju'V'IIVV.A.llA.U.A.
'V'v'-''UI..A.
'V'VL
-n.-r,nf"a"l"olhla
KEY WORDS:
urethral stricture, pelvic bones, pediatrics
Posterior urethral stricture after bony pelvic fracture and complete disruption of the prostatomembranous urethra is a misnomer, being neither urethral nor a stricture. It is either a fistulous or fibrous tract between the displaced prostate above and the bulbous urethra below the lesion.! posttraumatic urethral strictures in children have features warrant consideration the mEln2lge:me:nt. present our experience in the management of Ch].1dJ~en post-traumatic posterior urethral strictures. MATERIAL AND METHODS
....,."Ih""r'+...-.'''"''""'' ...
T
anastomosis 'rv'·''''' tomotic line was away from the rectum. Patients were followed flowmetry for 1 to 7 years. assessed as Lt~rJ L
"-""Tr",("\o"t·O-r·,.n
1""""".n,h ......
l--'.)()(
Between 1978 and 1985, 20 patients with suprapubic tubes indwelling were referred to us because of posterior urethral strictures secondary to bony pelvic fractures. Of the pwtleltlts 18 were 2 to 12 years old and 2 were 18 years old (the latter 2 had sustained the urethral were included because injury during childhood). The level of the was at prostatomembranous junction in 17 and across the prostate itself in 3 (fig. In 2 of the 20 patients had associated rectal injury that resulted in a rectourethral fistula and they were referred to us with a transverse COJlostolny addition a cystostomy Besides the routine and ... -o""' ..... "" urE~th.rOI;rra,ph.y assess the extent of obliterated fibrous tract as evaluate competency nism. Anastomotic months after the several years later. A was used in in whom the prostate was accessible and a combined tr2lnSDulblC a h,rln.1VY\1"nn.·n011"1Yloa I anastomotic was in 15 whom the prostate was markedly displaced One patient had complete obliteration of the entire length of the prostatic urethra; the urethral defect was by a distally based anterior bladder tube (fig. 2). The transpubic approach adopted in our series was essentially that of Waterhouse et al. 2 Dissection lateral and posterior to the prostate was avoided unless there was an associated rectourethral fistula. In addition, pubectomy was followed by cauterization of the bone edges to prevent new bone formation. The mucosa of the prostatic urethra was everted and pinned to the edges of the prostate gland to prevent its recession and to be sure that the anastomosis was actually mucosa-to-mucosa. .n"{7c,-rn.,n"1l"eratlve, and postoperhT
'-'!J'V.L ....
