Posterior Urethroplasty After Traumatic Urethral Stricture

This video shows urethroplasty in a young man with stricture of the urethra after a motor vehicle collision and pelvic fracture. The patient had prior primary realignment and was managed with Foley catheter. When his urethral catheter was removed, he developed scar in the urethra with complete obstruction at the level of the external sphincter. Posterior urethral strictures, refer to strictures located in the most proximal portion of the urethra (closest to the bladder). Their etiology often is the result of blunt trauma generally associated with a pelvic fracture like in case on video. It is estimated that ~10% of pelvic trauma fractures are associated with urethral injuries. These traumatic fractures may have enough force to completely separate the two ends of the urethra causing a distraction defect at the prostatomembranous junction in men. Injuries may result in impotence, stricture disease, and incontinence. Strictures may also be iatrogenic in nature (caused by prior medical intervention. ie radiation therapy), related to prior surgeries such as radical prostatectomy for cancer or transurethral resection of the prostate for enlarged prostates. Author: Dr. Jill Buckley