Primary realignment of posterior urethral rupture

We report the results of treatment of posterior urethral rupture [PUR] by primary realignment with some modifications of the technique. In this prospective study, 25 patients [mean age, 33.5 years; range, 18 to 70 years] in whom PUR had been proved underwent primary urethral realignment. All patients were evaluated postoperatively for urinary incontinence, erectile dysfunction, and urethral stricture. They were followed for a mean of 20 months [range, 9 to 27 months]. In 20 of 25 patients [80%], posterior urethral rupture was associated with pelvic fractures and in 2 [8%], bladder rupture was also present. None of the patients had urinary incontinence. Six patients [24%] had evidence of postoperative stricture that required urethral dilatation and/or direct vision internal urethrotomy in 2 or 3 procedures under local anesthesia. Erectile dysfunction was reported by 4 patients [16%] as a decreased quality of erection, all of whom responded to sildenafil. We believe that primary realignment of PUR is a simple procedure associated with low morbidity. It is recommended for patients who are stable and have no other significant intra-abdominal and pelvic organ injuries