[Traumatic rupture of the posterior urethra. Analysis of 87 cases at the Conakry University Hospital]

ABSTRACT

To report on our experience in the management of traumatic rupture of the posterior urethra. Eighty-seven patients with traumatic rupture of the posterior urethra were treated at the Department of Urology and Andrology of the Conakry University Hospital between January 1988 and December 2004. Trauma was caused by a car accident in 68 [78.2%] and by 72 hours after the accident. The others presented at a stage where urethral structure had already developed. Pelvic fracture was observed in 56 [64.4%] patients. The predominant presenting symptom was urinary retention in 62 [71.3%] patients, followed by bleeding per urethram in 59 [67.8%] and perineal hematoma in 23 [26.4%] patients. Treatment consisted of immediate realignment with a guiding catheter, deferred urethroplasty between the 8th and 10th day, or delayed urethroplasty, depending on the time elapsed after the injury. Good results were achieved in 32 [36.8%] and satisfactory results in 29 [44.8%] cases. Erectile dysfunction was noted in 19 [21.8%] patients. Treatment of ruptures of the posterior urethra remains controversial. Due to the fact that in our environment endoscopic realignment is not possible, deferred emergency end-toend urethrorraphy remains the method of choice for ruptures not associated with other serious lesions. In case of associated serious injuries, these are given priority as a life-saving measure before urethral repair