[Urethral rupture--primary repair and reconstruction].

Whether the posterior urethra can successfully be reconstructed depends mainly on the primary care, especially in the case of strictures secondary to trauma. Prior to surgery, primary care of the lesion is mandatory, including open suprapubic fistula, drainage of the cavum retii and of the perineal space, repositioning of the urethra and immediate stabilization of the pelvic ring by means of elastic procedures. In a second step, between 1978 and 1990 we performed bulbo-prostatic surgery in 27 patients with traumatic rupture of the posterior urethra. Based on extensive anatomic be studies on the relationship of the membranous urethra to the pelvic floor and to the arteries, veins and nerves, an operative approach via the perineal body was developed. Of 18 patients followed up, only 4 had flow rates of less than 15 ml/s. Retrograde urethrograms and micturition cystograms showed good results.