Acute surgical treatment of posterior urethral injuries.docVIP

 PAGE \* MERGEFORMAT 9 Acute surgical treatment of posterior urethral injuries 【Key Words】 Acute posterior urethral injury Male pelvic fracture caused by posterior urethral injury is the most difficult urological injury, acute illness and weight. Now our hospital since March 1992 to March 2004 collected 34 cases of treatment of patients with posterior urethral injuries, the report is as follows. A clinical data 1.1 General Information 34 patients, aged 15 to 68 years old, with an average 31-year-old. Complete posterior urethral rupture are associated with pelvic fracture complicated with shock in 16 cases, 9 cases of bladder rupture, blood pneumothorax, rupture of spleen in 2 cases, intestinal rupture in 4 cases. Injury causes: traffic accidents in 26 cases, eight cases of injury falling height. 34 cases in 31 cases of closed injury, 3 cases of open perineal urethral injury. 1.2 Treatment Correct shock, diagnosis and treatment of combined injury, hospitalization, within 12h after the surgery to be urethral rupture. 23 of them after a routine urethral realignment traction: intraoperative I bear a set of metal spies Foley catheter, from the mouth into the urethra, and then use the left index finger into the posterior urethra and urethra spies joined forces to Foley catheter into the bladder, to within the red balloon with normal saline 20 ~ 30ml, along with the body axis of 45 ° to the wheel traction, the former 3d pulling force of 400 ~ 600g, after 3 ~ 4d to 200 ~ 300 grams. 9 cases (including three cases of open injury) passing through anastomosis perineal urethral rupture, of which four cases of proximal urethra to find difficult to cut line after the bladder catheter inserted from the inside out to find the proximal urethra. 2 patients in critical condition due to a simple line of bladder fistulization. 2 Results 23 cases of posterior urethral realignment with traction, 3 ~ 6 weeks removal of cathet