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骨盆骨折合并后尿道破裂继发尿道狭窄,因其位于尿生殖膈上耻骨之后,故在处理上非常辣手,对较长的尿道膜部狭窄经会阴部手术暴露不够满意。1973年Waterhouse等采用经耻骨进路,它有直接暴露尿道膜部而无明显矫形学方面的并发症等优点。作者自1973年采用经耻骨修补同时附加带蒂大网膜移植的方法治疗本病15例,结果满意者13例(87％),部分尿失禁1例,狭窄复发1例。本组狭窄原因均为骨盆骨折并尿道膜部破裂所致,其中12例属完全性断裂,术前狭窄存在时间平均为13个月,狭窄长度平均2.5厘米,术前诊断包括分泌性尿路造影,逆行性尿路造影,排尿性膀胱尿道造影并内窥镜等检查,同时作膀胱内压测定而排除神经性膀胱。
Pelvic fracture combined urethral rupture secondary to urethral stricture, because it is located in the urogenital diaphragm suprapubic, so the treatment is very hot hands, long urethral membrane stenosis by perineal surgical exposure is not satisfied. In 1973, Waterhouse et al used a trans-pubic approach, which has the advantage of directly exposing the urethral membrane without significant complications of orthopedics. The authors treated 15 cases of this disease with pubic repair and pedicled omental transplantation since 1973, with 13 (87%) satisfied patients, 1 case of partial urinary incontinence and 1 case of recurrent stenosis. The causes of this group are due to pelvic fracture and urethral membrane rupture caused, of which 12 cases were completely ruptured, preoperative stenosis existed for an average of 13 months, the average length of 2.5 cm, the preoperative diagnosis including secretory urography , Retrograde urography, urinary bladder and urethrography and endoscopy and other tests, while the determination of bladder pressure and exclude neurogenic bladder.