S. MacDiarmid, FRCS-C, formerly Visiting Urological Fellow now Assistant Professor in Urology, University of Arkansas.
The importance of accurate assessment and conservative management of the open bladder neck in patients with post-pelvic fracture membranous urethral distraction defects
Article first published online: 21 NOV 2008
British Journal of Urology
Volume 75, Issue 1, pages 65–67, January 1995
How to Cite
MacDiarmid, S., Rosario, D. and Chapple, C.R. (1995), The importance of accurate assessment and conservative management of the open bladder neck in patients with post-pelvic fracture membranous urethral distraction defects. British Journal of Urology, 75: 65–67. doi: 10.1111/j.1464-410X.1995.tb07235.x
- Issue published online: 21 NOV 2008
- Article first published online: 21 NOV 2008
- Accepted for publication 26 September 1994
- Pelvic fracture;
Objective To review the pre-operative assessment of bladder neck competence and assess the success of non-operative management of the bladder neck in patients with pelvic fracture membranous urethral distraction defects.
Patients and methods A series of four patients with long-standing post-pelvic fracture urethral distraction defects and open bladder necks demonstrated on pre-operative investigation are presented.
Results All four patients were managed by perineal urethroplasty without surgery to the bladder neck. All patients were continent post-operatively despite the injury having ablated the distal sphincter mechanism.
Conclusion We believe that the majority of patients can be managed successfully by a non-operative approach to the bladder neck, sparing them the unnecessary operative morbidity of an abdomino-perineal repair, which should be reserved for those with obviously scarred or distorted bladder necks.