Volume 94, Issue 1 p. 134-136

Pelvic fracture-associated urethral injuries in girls: experience with primary repair

Lalgudi N. Dorairajan

Lalgudi N. Dorairajan

Department of Urology, Jawaharlal Institute of Postgraduate Medical Education and Research, Pondicherry, India

Search for more papers by this author
Harendra Gupta

Harendra Gupta

Department of Urology, Jawaharlal Institute of Postgraduate Medical Education and Research, Pondicherry, India

Search for more papers by this author
Santosh Kumar

Santosh Kumar

Department of Urology, Jawaharlal Institute of Postgraduate Medical Education and Research, Pondicherry, India

Search for more papers by this author
First published: 24 June 2004
Citations: 14
Lalgudi N. Dorairajan, Department of Urology, Jawaharlal Institute of Postgraduate Medical Education and Research, Pondicherry 605006, India.
e-mail: [email protected]

Abstract

OBJECTIVE

To present our experience with four urethral injuries in females accompanying a pelvic fracture, managed with primary repair or realignment of the urethra.

PATIENTS AND METHODS

There were three teenage girls and one adult (22 years old). All the patients had complete urethral injuries associated with a pelvic fracture from accidents. They were managed by immediate suprapubic cystostomy followed by repair or realignment of the urethra over a catheter on the same day. The catheter was removed after 3 weeks and a voiding cysto-urethrogram taken. Thereafter they were followed with regular urethral calibration.

RESULTS

All patients voided satisfactorily with a good stream; three were fully continent and the fourth had transient stress urinary incontinence. One patient needed dilatation at 2 months and another visual internal urethrotomy at 5 months. At a mean (range) follow-up of 33 (9–60) months all the patients had a normal voiding pattern and were continent; none developed vaginal stenosis.

CONCLUSION

Primary repair of the urethra, and if that is impossible, simple urethral realignment over a catheter, is the procedure of choice for managing female urethral injury associated with a pelvic fracture. The procedure has the additional advantage of reducing the risk of vaginal stenosis.