Radiotekhnika
Publishing house Radiotekhnika

"Publishing house Radiotekhnika":
scientific and technical literature.
Books and journals of publishing houses: IPRZHR, RS-PRESS, SCIENCE-PRESS


Тел.: +7 (495) 625-9241

 

Orthopedic correction of posttraumatic urethral strictures following con-servative treatment of multifocal pelvic injuries of male patients

Keywords:

Ya. G. Gudushauri – Ph.D. (Med.), Adults Traumatology Department, CITO named after N.N. Priorov Russian Ministry of HealthCare (Moscow) A.F. Lazarev – Dr. Sc. (Med.), Professor, Head of Adults Travumatology, Department CITO named after N.N. Priorov Russian Ministry of HealthCare (Moscow) A. V. Verzin – Ph.D. (Med.), Head of Microsurgery and Reconstructive Urology Department, FGBU «Research Institute of Urology» (Moscow)


The article presents the medium-term results of the surgical treatment with multifocal pelvic injuries that were complicated by urethral obliteration. Due to the patients’ critical conditions, accompanied by traumatic shock, all of them were treated conservatively (Volkovic position, hammock sling, skeletal traction). Malunion and insignificant displacement of pubic bones caused pubo-urethral impingement that led to obstructive changes in the lower urinary tract (obliteration, stricture). With time, as urethral stenosis increased, the condition was complicated by acute urinary retention, which required epicystostomy to be performed. In all cases, complex urologic and orthopedic examinations were performed in order to assess the length of the urethral stricture and its connection with bone fragments. The treatment strategy was determined according to the examination results and included two stages in all cases. The first stage comprised orthopedic treatment, while the second stage (after an average of 2 months) was aimed at urological correction (urethroplasty). Voluntary urination was restored in all cases. The follow-up period ranged from one to seven years. The obtained results demonstrated that the described technique of orthopedic correction of posttraumatic urethral strictures following conservative treatment of multifocal pelvic injuries is highly effective.
References:

 

  1. Stelmakh K. K. Profilaktika oshibok i oslozhnenijj v lechenii tjazhelojj travmy taza metodom chreskostnogo osteosinteza // Sb. tezisov konferencii, posvjashhennojj pamjati prof. K. M. Sivasha. M. 2005. S. 346.
  2. CHerkes-Zade D.I. KHirurgicheskoe lechenie povrezhdenijj taza i ikh posledstvijj. M.: Aktovaja rech. 2000. S. 5, 10.
  3. JAkimov S.A. Otdalennye rezultaty operativnogo i konservativnogo lechenija povrezhdenijj kostejj i sochlenenijj taza: Dis. ... kand. med. nauk. M. 2000. S. 79–101.
  4. Bennemann R. Untersuchungen am iliosacralgelenkdes menschen // Anat. Anz. 1979. Bd. 146. Erganzungsh. Bd. 1. S. 187–189.
  5. Gilliland et al. Fractures of acetabulum and pelvis. Cambell\'s // Operative Orthopaedics. P-2962.
  6. Tile M. Acute pelvis fractures: Causation and classification // J. Am. Acad. Ortop. Surg. 1996. № 4. P. 143-151.
  7. Djatlov M.M. Slozhnye povrezhdenija taza. CHto delat? Gomel: IMMS NAN Belorussii. 2006.
  8. A.c. 1050694 SSSR, A 61 17/18. (SSSR). Apparat dlja repozicii tazovykh kostejj / G.A. Ilizarov. Opubl. 30.10.83. Bjul. № 40.
  9. Krakovskijj N.I., Zolotarevskijj K.D., Nichiporenko K.D. Ostanovka profuznogo krovotechenija iz tazovykh venoznykh spletenijj // KHirurgija. 1974. № 6. S. 34–37.
  10. Kuznecov JI.E. Povrezhdenija taza u detejj (morfologija, biomekhanika, diagnostika). M.: Folium. 1994. S. 4, 12.
  11. Litvina E.A., Skorogljadov A.B., Gordienko D.I. Odnoehtapnye operacii pri mnozhestvennojj i sochetannojj travme // Vestnik travmatologii, ortopedii im. H.H. Priorova. 2003. № 3. S. 11–12.
  12. Movshovich I.A. Operativnaja ortopedija: Rukovodstvo dlja vrachejj. M.: Medicina. 1994. S. 190.
  13. Kogan M.I. striktury uretry u muzhchin. Rekonstruktivno-vosstanovitelnaja khirurgija. M.: Prakticheskaja medicina. 2010. 143 s.
  14. Sivkov A.V., Verzin A.V., Penkov P.L., Lazarev A.F., Solod EH.I. Gudushauri JA.G. Mekhanizm povrezhdenija mocheispuskatelnogo kanala pri travme kostejj taza u muzhchin // EHksperimentalnaja urologija. 2012. № 1. S. 72–75.
  15. Patent № 2492830 (RF). Sposob khirurgicheskogo lechenija sochetannykh zastarelykh povrezhdenijj tazovogo kolca i nizhnikh mochevykh putejj u muzhchin / A.F. Lazarev, A.V. Sivkov, A.V. Verzin, JA.G. Gudushauri, P.L. Penkov, A.F. Lazarev, M.G. Kakabadze, A.A. Lazarev.

 

© Издательство «РАДИОТЕХНИКА», 2004-2017            Тел.: (495) 625-9241                   Designed by [SWAP]Studio