The surgery of trauma of the male urethma

ABSTRACT

Urinary retention and blood in the urinary meatus are the common signs of trauma of the urethra which may be brought about by crushing injuries such as the "straddle" type, or penetrating injuries from spicules of bones in fractures of the pelvis. The paths of urinary extravasation guide to surgeon in his drainage incisions. The treatment which must be started even on the merest suspicion of a trauma, must be divided into suprapubic drainage of urine and definitive repair. In our hands, the wide anatomic exposure of the injured urethra through the perineo-scrotal region allows for good excision on the scar tissue and correct suturing of defects, employing usually overlying tissues in several layers. We have had to little experience with the use of free skin grafts to be able to write enthusiastically about it, although undoubtedly in selected cases this operation holds a place. (Summary)