Citation

de Oliveira PS, de Oliveira TR, Martinho D, Martins F. Urol. Ann. 2017; 9(4): 403-406.

Affiliation

Department of Urology, School of Medicine, University of Lisbon, Santa Maria Hospital, Lisbon, Portugal.

Copyright

(Copyright © 2017, Medknow Publications)

DOI

10.4103/UA.UA_92_17

PMID

29118550

PMCID

PMC5656973

Abstract

Although posterior urethral injury occurs almost always in association with pelvic fracture, it may result from severe trauma to the perineum with its associated potential lethality and severe morbidity. Early primary endoscopic realignment over a urethral catheter can be attempted, although an immediate suprapubic tube placement remains the standard of care. Definitive treatment consists of elective open posterior anastomotic urethroplasty through a perineal approach. The authors present a 53-year-old man who sustained total, massive perineal destruction resulting from work accident with an agricultural implement. Immediate suprapubic tube placement was performed followed by delayed elective transperineal anastomotic posterior urethroplasty. A major multidisciplinary approach was necessary in the management strategy, including orthopedic, general, plastic, vascular surgeries, and reconstructive urology teams. At a later stage, with the patient stabilized and recovered from major, life-threatening lesions dealt with by a multidisciplinary team, urethral reconstruction can be undertaken with ultimate good functional outcomes.

Language: en

Keywords

Multiple fractures; pelvic bones; posterior urethral stricture; reconstructive surgery; surgical anastomosis; trauma