[Therapeutic strategy apropos of 122 cases of early disclosed traumatic rupture of the urethra].

When ureteral rupture is suspected after trauma with fracture of the pelvis, insertion of a suprapubic catheter is required as an emergency measure. Ureteral lesions must be repaired early by the 5th to 10th day after trauma. Pyelography or retrograde ureterography is required to determine whether there is total or partial rupture and the degree of damage is identified endoscopically. We operated 73 total ruptures in deferred emergency situations (58 transpubic, 14 perineal approaches) and achieved good results in 80%. There were also 41 partial ruptures treated with an indwelling catheter in which 21 developed strictures requiring secondary uretrotomy. In three particular situations (anorectal damage, infected perineal wound, polytrauma with head trauma), in 8 patients were managed with suprapubic drainage alone before repair 3 months later. Different complications, including stricture and impotency were observed.