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Posterior urethral injuries in children

Publication at Second Faculty of Medicine |


Aim of the study: To present experience with the treatment of posterior urethral injuries in 13 patients in the period 1990 - 2010 Material and methods: Over the past 20 years, we have treated 13 boys aged 5 - 16 with posterior urethral injuries. Adolescence was predominant.

The mechanism of the injuries included falls from above with an impact on the perineum, collision with a heavy truck, collision with a train, impact with a heavy metal rod. jatrogen injuries posterior ureters were after treatment of incontinence gracilis plastic and colorectoplasty for hirschsprung's disease. one patient was admitted for a war injury with a firearm. in one patient the method of reconstruction of urethral intussusception was used, in nine patients an oblique anastomosis with longitudinal incision of both ends of the ruptured urethra after excision of the devitalized parts. two patients recovered after suprapubic vesicoma, one underwent only hemostasis. Results: Twice we observed a good result only after epicystostomy. in six children they were necessary reoperation due to stricture in the anastomosis. in two children with extensive pelvic and urethral injuries in the subvesical and bulbar part, 4 additional operations were necessary to restore urethral patency, in one boys with avulsion of the rectum and posterior urethra required 3 reoperations.

Conclusion: Delayed anastomosis of the posterior urethra after securing lower urinary tract drainage by vesicostomy gives better results than urgent performance, which should be reserved for countless cases of open accidents. is the possibility of restoring the patency of the posterior urethra at long distances of the stumps by repeated operations. These performances led to good functional results in our group despite the disadvantage of shortening the penis.