First aid and general principles of treatment of urethral injuries accompanying pelvic fractures.

Adequate first aid and operation done in due time with participation of an urologist enables the successful primary repair of urethral injuries accompanying pelvic fractures. Suprapubic cystostomy, drainage of the pre- and subvesical space towards the perineum, splinting of the urethra with an ureteral catheter and ureteral or at least paraureteral sutures done through a perineal incision are the principal requirements. Avoidance of catheterization, but eventually emptying of the bladder through a suprapubic puncture in the preoperative period and treating the urethra with greatest gentleness in time of repair should prevent additional injury to the urethra, in most cases only partially torn. Further development shall lead to giving up the theory of two-stage operations of urethral injuries.