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Review
. 2015 Mar;13(1):37-42.
doi: 10.1016/j.aju.2014.11.007. Epub 2015 Feb 14.

Pelvic-fracture urethral injury in children

Judith C Hagedorn  1 , Bryan B Voelzke  1
Affiliations
Review

Pelvic-fracture urethral injury in children

Judith C Hagedorn et al. Arab J Urol. 2015 Mar.

Abstract

Objective: To review paediatric posterior urethral injuries and the current potential management options; because urethral injury due to pelvic fracture in children is rare and has a low incidence, the management of this type of trauma and its complications remains controversial.

Methods: We reviewed previous reports identified by searching the PubMed Medline electronic database for clinically relevant articles published in the past 25 years. The search was limited to the keywords 'pediatric', 'pelvic fracture', 'urethral injury', 'stricture', 'trauma' and 'reconstruction'.

Results: Most paediatric urethral injuries are a result of pelvic fractures after high-impact blunt trauma. After the diagnosis, immediate bladder drainage via a suprapubic cystotomy, or urethral realignment, are the initial management options, except for a possible immediate primary repair in girls. The common complications of pelvic fracture-associated urethral injury include urethral stricture formation, incontinence and erectile dysfunction. Excellent results can be achieved with delayed urethroplasty for pelvic fracture-associated urethral injuries.

Conclusion: Traumatic injury to the paediatric urethra is rare and calls for an immediate diagnosis and management. These devastating injuries have a high complication rate and therefore a close follow-up is warranted to assure adequate delayed repair by a reconstructive urologist.

Keywords: ED, erectile dysfunction; Injury; PFUI, pelvic fracture-associated urethral injury; Paediatric; Pelvis; RUG, retrograde urethrography; Reconstruction; US, ultrasonography; Urethra; VCUG, voiding cysto-urethrography.

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