Pardillo AME, Álvarez BO, Toirac DRR

Language: Spanish
References: 9
Page: 92-98
PDF size: 346.76 Kb.

ABSTRACT

Genitourinary tract injuries are common in patients with severe trauma. Diastasis of the pubis and fractures of the pubic branches can lead to urethral rupture in male patients. The management of this trauma is complex. We describe a rare case of a patient with symphysis pubis diastasis accompanied by posterior urethral rupture. A 45-year-old male patient after a motor vehicle accident is brought conscious to the emergency room with severe pelvic pain and urge to urinate. Radiological studies show diastasis of the symphysis pubis. Urethrocystography showed contrast extravasation at the level of the posterior urethra, making bladder filling impossible. Joint care by Traumatology and Urology allows reduction of the symphysis pubis. The bladder approach is performed by infra umbilical median incision, which allows the Davis maneuver, achieving splinting of the urethra. Urethral catheter and cystostomy tube with drainage in the Retzius space are left. In these lesions, diagnosis, prompt management, correct evaluation and appropriate selection of the type of intervention is the most important. The suspicion of urinary tract injury after pelvic trauma is high. Treatment requires extensive knowledge of anatomy and reconstructive techniques.

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