FRACTURA PELVICA. URETRA POSTERIOR

Joshi PM¹, Desai DJ², Shah D³, Joshi D¹, Kulkarni SB¹.

Author information:

¹Kulkarni Reconstructive Urology Center, 3, Rajpath Society, Opposite Vanaz Engineering, Paud Road, Pune, 411 038.

²Kulkarni Reconstructive Urology Center, 3, Rajpath Society, Opposite Vanaz Engineering, Paud Road, Pune, 411 038; Toowoomba Urology, University of Queensland, Queensland, Australia. Electronic address: ddesai@toowoombaurology.com.au.

³Star Imaging, Joshi Hospital, Pune, 411 038.

Urology. 2017 Jan 11. pii: S0090-4295(17)30016-X. doi: 10.1016/j.urology.2017.01.004

Abstract

Pelvic fracture urethral injuries (PFUI) commonly result from motor vehicle collisions. The mechanism of injury conventionally thought was a shearing injury at the membranous urethra, which would destroy the striated sphincter. Continence would therefore depend on the bladder neck. Striated sphincter and site of injury has not been shown clearly on preoperative imaging. We demonstrate a our protocol of performing MRI whereby the membranous sphincter is seen intact and the injury is shown to be at the membrano-bulbar junction contrary to conventional belief. This suggests that surgical reconstruction can be undertaken preserving both sphincter mechanisms improving postoperative continence.