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.