[Non-instrumental traumatism of the urethra: our experience].

OBJECTIVES

To report our experience in the diagnosis and treatment of this type of urologic trauma. The results are analyzed in order to determine the best therapeutic approach and the literature reviewed.

METHODS

The series comprised 9 males; 6 had rupture of the posterior urethra and 3 had anterior urethral trauma. Four cases underwent suprapubic drainage and delayed definitive treatment; early realignment of the urethra was performed in 3 cases, and the only patient with a penetrating injury immediately underwent a repair procedure. Urethral urethrotomy sufficed in one patient with partial rupture of the anterior urethra. Delayed treatment consisted of end-to-end anastomosis; one patient required pubic partial resection.

RESULTS

Good results were achieved by end-to-end anastomosis; 3 patients have been discharged and one required internal urethrotomy. Two of these patients have remained impotent. The patients submitted to early realignment of the urethra are managed well with regular dilatation and internal urethrotomy in some cases.

CONCLUSIONS

We found suprapubic drainage and delayed repair superior to early realignment in those cases with posterior urethral injury. In our view, delayed end-to-end anastomosis, with or without pubic resection can be performed in virtually all cases. We advocate immediate repair of penetrating injuries to the anterior urethra.