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  • Title: The type of urethroplasty for a pelvic fracture urethral distraction defect cannot be predicted preoperatively.
    Author: Andrich DE, O'Malley KJ, Summerton DJ, Greenwell TJ, Mundy AR.
    Journal: J Urol; 2003 Aug; 170(2 Pt 1):464-7. PubMed ID: 12853800.
    Abstract:
    PURPOSE: Pelvic fracture urethral distraction defects (PFUDDs) are generally treated surgically by a so-called progression approach consisting of 4 steps to achieve a tension-free bulboprostatic anastomosis. Implicitly the need for each step in turn is predictable according to the length of the defect on preoperative x-ray. MATERIALS AND METHODS: In 62 evaluable patients with PFUDD the length of the radiological defect was compared with the surgical steps that subsequently proved necessary to achieve a tension-free bulboprostatic anastomosis. RESULTS: Except at the extremes of length there was no association between defect length and the scale of the surgery performed. CONCLUSIONS: Surgeons preparing to repair an apparently short PFUDD cannot assume that simple repair is all that is necessary.
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