The type of urethroplasty for a pelvic fracture urethral distraction defect cannot be predicted preoperatively.

Abstract

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. 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. Except at the extremes of length there was no association between defect length and the scale of the surgery performed. Surgeons preparing to repair an apparently short PFUDD cannot assume that simple repair is all that is necessary.