Surgical Treatment of Old Pelvic Ring and Lower Urinary Tract Injuries in Men

Abstract

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