Classification of pelvic fracture urethral injuries: Is there an effect on the type of delayed urethroplasty?

Abstract

The posterior urethral injury due to pelvic fracture is a challenging problem. Because pelvic fractures are widely varying in severity, direction and mechanism, a wide spectrum of pelvic fracture urethral injuries (PFUIs) is clinically identified. Previously published data indicate that the proposed classifications of PFUIs are neither ideal nor universally acceptable. Moreover, these classifications might not have a significant effect on the delayed definitive techniques of urethral reconstruction. The currently available classifications and management strategies of PFUIs lack consensus and are based on accumulated surgical experience and clinical case studies. In the current era of evidence-based medicine there should be clear and appropriate guidelines for managing PFUIs, based on meta-analysis of well-designed controlled studies and evidence-based surgical science. In this way several controversies in the management of PFUIs will be resolved and the quality of life of patients who have sustained PFUIs will be improved.

Keywords: AAST, American Association of Surgery of Trauma; Classification; PFUI, pelvic fracture urethral injury; Pelvic fracture; Reconstruction; Urethra; Urethroplasty.