Therapeutic Results by Urethrographic Classification for Male Posterior Urethral Injury Associated with Pelvic Fracture

Park, Seung Oh; Yoon, Jong Byung

Abstract

The author analyzed 60 cases of urethrography of patients with posterior urethral injury, from 1971 to 1980 at the Department of Urology, Busan National University Hospital, and according to the radiographic findings, presents a new classification of posterior urethra1 injury; type I, type II, type III and type IV. Type II and IV were most common (70%). The most common pattern of pelvic fractures was bilateral fracture of pubic rami, accounting for 27 cases of total. Therapeutic goals of posterior urethral injury are to prevent late complications such as stricture, impotence and incontinence. In the past we used urethral Foley catheter indwelling, primary realignment and primary reanstomosis for posterior urethral injury. Following primary realignment, the incidence of stricture was 18 cases (86%), impotence 9 cases (43%) and incontinence 3 Cases (14%) out of 21 cases. In Foley catheter indwelling the incidence of stricture was 67%, impotence 33% and incontinence 8% out of 12 cases. Now we adopt cystostomy alone with or without delayed pull-through (Badenoch) urethroplasty for posterior urethral injury. After cystostomy alone, the incidence of stricture is 2 cases (22%), impotence 2 cases (22%) and incontinence 1 case (11%) out of 9 cases. In cystostomy with delayed urethroplasty the incidence of stricture is 1 case (25%), impotence 2 cases (50%) and no incontinence out of 4 cases.