RT Journal Article
SR Electronic
T1 ‘Poles apart presentation’: diagnosis and management of iatrogenic posterior urethral false tract in cases of pelvic fracture urethral injury
JF BMJ Case Reports
JO BMJ Case Reports
FD BMJ Publishing Group Ltd
SP e231166
DO 10.1136/bcr-2019-231166
VO 12
IS 8
A1 Devanshu Bansal
A1 Sanjay Kumar
A1 Siddharth Jain
A1 Prem Nath Dogra
YR 2019
UL http://casereports.bmj.com/content/12/8/e231166.abstract
AB Iatrogenic creation of false tract in posterior urethra while managing a case of pelvic fracture urethral injury is a dreadful complication. The spectrum of presentation ranges from complete urinary incontinence to urinary retention. We describe three such cases created due to railroading or attempted repair. Case 1 presented with total urinary incontinence following open perineal urethroplasty for posterior urethral trauma while two cases presented with failure to void after endoscopic or open surgical management for the same. One patient was managed with endoscopic resection of the septum between the false passage and true posterior urethra; two cases required redo urethroplasty. All patients voided well postoperatively and were continent. Surgeon experience and meticulous endoscopic evaluation are the keys to success. Forceful attempt at per urethral catheter placement in the acute setting should be avoided. Blind railroading of the catheter and unnecessarily forceful passage of suprapubic metal bougie during urethroplasty should be condemned.