Treatment of complex posterior urethral strictures with urethroplasty via transpubic approach after pelvic fracture

Abstract

Objective To evaluate the efficacy and safety of urethroplasty via transpubie ap-proach in treatment of complex posterior urethral strictures after pelyic fracture. Methods Urethroplas-ty via transpubic approach was done on 26 patients (21 males and 5 females, at mean age of 26 years) with complex posterior urethral strictures. Posterior urethral stricture was 2.5-4.0 cm long in 23 patiens and > 4.0 em in three. There were five patients with urethratresia. The perioporative complications and operative effect were evaluated after the broken ends of the urethra was thoroughly resected and treated with end-to-end anastomosis. Results A follow-up for 1-7 years ( mean 4 years) showed successful op-eration in 22 patients (85%), with normal urination and without complications like osteitis pubis, pelvic disassociation, pelvic instability or urinary incontinence. But obstructed urination was found in one (4%) and failed operation in three (11%). Conclusions Urethroplasty via transpubic approach takes advantages of precise and thorough scar excision, less complications and long term curative effect and is clinically feasible and safe for patients with complex posterior urethral stricture. Key words: Pelvic fractures; Posterior urethral stricture; Urethroplasty; Transpubie ap-proach