Webster G D
Division of Urology, Duke University Medical Center, Durham, North Carolina.
Urol Clin North Am. 1989 May;16(2):303-12.
Membranous urethral disruption secondary to pelvic fracture often results in an obliterative stricture. Most of these lesions can be repaired by a one-stage procedure provided certain maneuvers are accomplished to facilitate approximation of the bulbar to the prostatic urethra: urethral mobilization as far proximal as the suspensory ligament of the penis, separation of the corporal bodies, excision of a wedge of the inferior surface of the pubis exposed by corporal body separation, and on occasion, routing of the mobilized urethra around the corporal body. With these methods, even lengthy defects can be bridged to create a tension-free anastomosis.
骨盆骨折继发的膜部尿道断裂常导致闭锁性狭窄。如果采取某些操作以促进球部尿道与前列腺尿道的靠拢,大多数此类损伤可通过一期手术修复:将尿道尽可能向近端游离至阴茎悬韧带,分离阴茎海绵体,切除因海绵体分离而暴露的耻骨下表面楔形组织,有时还需将游离的尿道绕过海绵体。采用这些方法,即使是较长的缺损也能桥接起来,形成无张力吻合。