Twenty eight patients with old postpartum ruptures of pubic symphysis complicated by functional bladder disorders were operated on during the period from 2000 to 2013. Time interval between vaginal delivery and pelvic ring stabilization made up from 1 month to 8 years. Clinical and roentgenologic examination enabled to detect predisposing factors for neurogenic, i.e. hyperactive bladder development that were treated surgically. In all cases plate osteosynthesis for pubic symphysis and fixation of sacroiliac joint with cannulated screws was performed. Subjective improvement of patients’ condition as well as the results of uroflowmetry and complex urodynamic investigation enabled to conclude that orthopaedic reconstruction of pelvic ring in old obstetric ruptures of pubic symphysis was an effective and reliable technique for the treatment of bladder dysfunction.
Surgical treatment results for 56 men with old pelvic bones and junctions injuries complicated or associated with either strictures or obliteration of membranous and bulbomembranous urethral segment are presented for the period from 2002 to 2013. Terms after trauma made up from 1 month to 6 years, mean age of patients - 36 (16-66) years. All patients were admitted with epicystoma and history of 3-5 failed surgical interventions directed to uresis restoration. The pattern of pathologic mobility, degree of pelvic ring injury, length of urethral defect, and connec- tion of urethra with either bone fragments or displaced pelvic bones were assessed during complex urologic and traumatologic examination. Treatment tactics, i.e. one- or two-step, was chosen depending on the diagnosed injuries. In two-step treatment tactics orthopaedic step always preceded the urologic one (urethra plasty) that followed in about 2 months after primary intervention. Observation terms made up from 1 month to 6 years. Loco-motor function was restored in all patients, urination - in 54 of 56 patients. Thus, elaborated method of surgical treatment for old concomitant pelvic ring and lower urinary tract injuries showed high efficacy in patients with posttraumatic urethral stricture or obliteration
Surgical treatment results for 56 men with old pelvic bones and junctions injuries complicated or associated with either strictures or obliteration of membranous and bulbomembranous urethral segment are presented for the period from 2002 to 2013. Terms after trauma made up from 1 month to 6 years, mean age of patients - 36 (16-66) years. All patients were admitted with epicystoma and history of 3-5 failed surgical interventions directed to uresis restoration. The pattern of pathologic mobility, degree of pelvic ring injury, length of urethral defect, and connec- tion of urethra with either bone fragments or displaced pelvic bones were assessed during complex urologic and traumatologic examination. Treatment tactics, i.e. one- or two-step, was chosen depending on the diagnosed injuries. In two-step treatment tactics orthopaedic step always preceded the urologic one (urethra plasty) that followed in about 2 months after primary intervention. Observation terms made up from 1 month to 6 years. Loco-motor function was restored in all patients, urination - in 54 of 56 patients. Thus, elaborated method of surgical treatment for old concomitant pelvic ring and lower urinary tract injuries showed high efficacy in patients with posttraumatic urethral stricture or obliteration
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