Basilio OA, Luna TA

Language: Spanish
References: 8
Page: 55-57
PDF size: 47.40 Kb.

ABSTRACT

A complete an current revision concerning the handling of traumatic lesion of the male urethra is made. We are reminded that the urethra is divided in three anatomical portions: prostatic, membranous and spongy. Urethral lesions pose a challenge to the surgeon due to their great morbidity. The main cause for rupture is the closed trauma, direct trauma or quick deceleration, however, lesions due to projectiles or sharp instruments are not rare. The fracture of the pelvis is associated with posterior urethral rupture in 95% of the cases if the lesion is superior. The diagnose must be suspected in patients with perianal pelvic trauma, closed or open, being the initial evaluation fundamental. Data such as hematic point (blood in urethral meatus), peri-scrotal edema or hematoma, strongly suggest the presence of urethral rupture 4. The rectal tract generally evidences an elevated and hardly palpable prostate. The retrograde urethrogram is the best diagnostic method. The treatment of urethral trauma is always surgical, initially with a derivation of orine by cystostomy, adding ferulization or primary repairing. Impotence, stenosis and incontinency are the most frequent complications in this type of lesions.

REFERENCES

1. Prives ML. Anatomía humana. Tomo 1. 3a edición Mir. Moscú.

2. McAninch JW. Genitourinary Trauma. In: Mattox K, Moore E. Feliciano D. Editors. Trauma. Appleton & Lange 1988: 309-331.

3. Paulson D. Genitourinary Trauma (Chapt 11) In: Moylan J. Editor. Trauma surgery. Lippincott Company. Philadelphia. 1988: 309-331.

4. Atls. American College of Surgeons: Committee on Trauma. Advanced trauma life support course. Chicago 84.

5. Moore E, Cogbill T. Establecimiento de la escala de lesión traumática orgánica. En: Clínicas Quirúrgicas de Norteamérica. Interamericana. 1995; 2: 273-285.

6. Koratim MM. Pelvic fracture uretral injuries; evaluation of various methods of management. Journal Urology 1996; 156(4): 1288-91.

7. Koch MO. Primary realignment of prostatomembranous uretral disruptions. Semin Urology 1995; 13(1): 38-44.

8. Dhabuwala CBH et al. Impotence following delayed repair of prostatomembranous uretral disruption. Journal Urology 1990; 144(3): 677-8.