Klotz T, Derakhshani P, Vorreuther R, Engelmann U
Klinik und Poliklinik für Urologie, Universität zu Köln.
Urologe A. 1998 Jan;37(1):79-82. doi: 10.1007/s001200050153.
We report on a complete longitudinal rupture of the urethra in combination with a rupture of the pubic symphysis and pelvic fracture during spontaneous vaginal delivery. Only after stabilisation of the pelvic fracture by external skeletal fixation adaptation of the urethra was possible. Three weeks later after removing of the transurethral catheter a mild stress incontinence could be observed. In the follow up one year later the patient was completely continent. The cosmetic result was satisfactory. There was no cystocele. An unclear haematuria after delivery needs a meticulous urological examination. Early repair of urethral disruption minimize the risk of severe incontinence. Coordinated care between the trauma surgeon and urologist is required for successful treatment of this rare combined injury after birth.
我们报告了一例在自然阴道分娩过程中尿道完全纵向破裂，同时合并耻骨联合破裂和骨盆骨折的病例。只有在通过外固定架稳定骨盆骨折后，才有可能对尿道进行修复。经尿道导管拔除三周后，观察到轻度压力性尿失禁。在一年后的随访中，患者完全控尿。美容效果令人满意。没有膀胱膨出。产后不明原因的血尿需要进行细致的泌尿外科检查。早期修复尿道断裂可将严重尿失禁的风险降至最低。对于这种罕见的产后合并伤，创伤外科医生和泌尿外科医生之间的协调护理是成功治疗的必要条件。
