Ces Urol 2011, 15(1):35-44 | DOI: 10.48095/cccu2011006

Urological complications of pelvic fractures

Jana Hlaváčová¹, Milan Hora¹, Tomáš Pavelka², Viktor Eret¹, Jiří Ferda³, Jan Bulka⁴

¹ Urologická klinika LF UK a FN, Plzeň

² Klinika ortopedie a traumatologie pohybového ústrojí LF UK a FN, Plzeň

³ Radiodiagnostická klinika LF UK a FN, Plzeň

⁴ Radiodiagnostické oddělení LF UK a FN, Plzeň

Aim:
Summarized our own experience and results of urological complications of pelvic fractures.

Methods:
In the period between January 1998 and December 2009 we treated 38 patients for severe urinary tract injury following pelvic trauma.

Results:
The mean age was 40 years (range 21-71). The urinary bladder rupture (UBR) was diagnosed in 21 patients. Two men had concomitant posterior urethral trauma. After the UBR was diagnosed, all UBRs were treated by operative revision and urinary bladder suture within 24 hours. The posterior urethral trauma (PUT) was diagnosed in 19 patients. We performed acute revision and primary urethral realignment in nine patients. Epicystostomy was introduced in nine patients, one patient was primary introduced a urinary catheter. We indicated posterior resection urethroplasty after three months in five patients. In 13 men with partial rupture of the urethra was not needed further treatment. Erectile dysfunction appeared in seven men.

Conclusion:
The UBR does not cause neither a diagnostic nor a curative problem. In suspicion of PUT a retrograde urethrography is necessary before instrumentation. After that we perform introduction of epicystostomy or primary realignment. The PUT is followed by posterior resection urethroplasty after 12 weeks.

Keywords: pelvic fracture, urethral trauma, retrograde urethrography, bladder rupture, urethral stricture

Received: July 26, 2010; Accepted: November 15, 2010; Published: January 1, 2011