男童骨盆骨折相关后尿道断裂的手术治疗策略

ABSTRACT：ObjectivePelvic fracture urethral distraction defect （PFUDD）is relativelyrare among boys and difficult to manage.Thistudyaims to explore the efficacyof progresive urethralanastomosis inthetreatmentof this disease.Methods A total of 34 malechildren with PFUDDwho wereadmitted toourhospitals duringJan.208andDec.022 were collected.The therapeutic efects and the occurrence of postoperative complications were observed and analyzed.ResultsAllcases were traumaticpelvicfractures，nudingfallijuriesin3cases，trafic-relatedimpactinjuriesin21casesandpelviccushjuries in 10cases.Urethroplastywas performedatleast 3 months after theinitial rauma orafterthefailureofthelastintervention.The mean length of the urethral defect was 3.0cm ，with a range of 1.5 to 5.5cm .Three cases complicated with urethrorectal fistula underwent urethroplastyconcomitant with fistula repair.Allchildren were followedupforan average of 65.5 months，with a range of 5.0 to 155.0 months，with 32 cases （94.1% ）achieving successful treatment. Two cases with stricture recurrence were curedbyasecond operation.Threecases with mildurinaryincontinence were improvedafterhalfa yearofpelvicfloor muscle rehablitation training.ConclusionThe progresiveurethralanastomosis strategycan yieldarelatively high successrate.The trans-inferior-pubic resection or simpler approaches can be adopted for the treatment of PFUDD in over 90% of male children.

KEY WORDS： pelvic fracture；urethral stricture；urethral distraction defect；urethral anastomosis； surgical strategies摘要：目的男童骨盆骨折后尿道断裂（PFUDD）罕见且治疗困难，本研究旨在探讨渐进式尿道吻合术治疗该类患儿的效果。（剩余8305字）