Kenneth J. Mackinnon

Management of Prostatomembranous Urethral Disruption: 13-Year Experience

AbstractInitial management of all cases of prostatomembranous urethral disruption at our hospital since 1965 has consisted of suprapubic cystostomy alone. In addition, a significant number of cases treated elsewhere with this technique (originally proposed by Johanson in Sweden) were referred to this institution for definitive treatment of the obliterated urethra. The results have been reviewed with reference to the surgical technique, need for additional surgery, urethral patency, urinary control and sexual potency.Of 61 cases managed with this method 58 ruptures were complete and 3 were incomplete. The incomplete cases required no treatment other than the initial cystostomy. Urinary continence without stricture was achieved in 60 cases. Reoperation was required for stricture in 2 cases.The low incidence of sexual impotence (10 per cent or less, depending on the eventual pattern in the children included in the series) had led some observers to suggest that preselection or faulty injury classification mig...