[The simultaneous management of rupture of the urethra and the symphysis (author's transl)]. / Die simultane Versorgung der Harnröhrenruptur und Symphysensprengung

ABSTRACT

The combined injury-rupture of the urethra and the symphysis--is no respecter of the surgical disciplines, urology and accident surgery. Therefore, a combined operating team from both specialties should simultaneously undertake primary care. First comes the restoration of urethral continuity. The retropubic approach favors the gaping pubic symphysis. A stationary osteosynthesis of the symphysis with an AO-tension band plate follows. In that way the urethra and its suspension apparatus are brought into the right position. Immobilization damage is avoided through exercise stability which allows early maximum stress of the patient. A persisting instability of the anterior pelvic girdle through shearing force is a risk in reconstructive urethral surgery. Simultaneous primary care is contraindicated in cases of irreversible shock and life-threatening injury where the need for surgery is urgent.