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TRAUMA TO THE PELVIC GIRDLE AND THE URETHRA AND ITS TREATMENT
Author(s) -
SANTAELLA Professor RAFAEL ALCALA
Publication year - 1946
Publication title -
british journal of urology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.773
H-Index - 148
eISSN - 1464-410X
pISSN - 0007-1331
DOI - 10.1111/j.1464-410x.1946.tb10604.x
Subject(s) - urethra , medicine , cystostomy , suprapubic cystostomy , surgery , catheter , perineum , urethroplasty , pelvic fracture , pelvis
Summary All these cases, as we have pointed out, were treated according to the following routine, which we believe, gives the best results‐namely, cystostomy immediately following the accident, followed by perineotomy a month later. This interval allows a period of rest, and an opportunity for disinfection of the bladder and the traumatized area, and the reconstruction of the urethra. Special interest, we consider, attaches to this line of treatment for complete rupture of the urethra, with regard to the following points: 1. The time of the intervention. 2. The subsequent perineal catheter. 3. The disinfection and care of the case, between operations. 4. The closing of the cystostomy. The operation to divert the urine should follow immediately after establishing the diagnosis, and by this means extravasation into the perineum will be avoided. A catheter may be placed in position if necessary, once the perineotomy has been done. For this, one should use a No. 16 Charritre catheter, adopting the technique of Fey and Hortolmey. The thorough cleansing of the bladder and the efficiency of the catheter are indispensable, if a good result is to be obtained. Rarely it may be necessary to continue urethral dilatation with metal sounds, after the end of hospital treatment. The evidence afforded by urethrography is invaluable as is clear from the reported cases; for example the course, permeability, and other features of the damaged portion of the urethra are made clear.