[The prevention and treatment of posttraumatic strictures of the posterior urethra in patients with pelvic bone fractures].

Urethral strictures resultant from hip fractures were examined and treated in 140 patients admitted to hospital with multiple attendant traumas: rupture of the bladder and abdominal organs, rib and limb fractures, renal injuries. All of them underwent epicystostomy followed in 3--4 months by urethroplasty. Drainage of the bladder and paracystic fat was passive in 38 and active in 102 patients. Passive drainage, common in urological practice, failed to yield satisfactory results because of deficient urine outflow from the bladder and gave rise to various complications: phlegmons, femoral osteomyelitis, pyelonephritis, urosepsis. Fourteen patients developed urinary fistulas, four subjects had a large postoperative hernia involving the bladder. The adverse effects made urethroplasty problematic. With active drainage, the bladder and paracystic fat were continuously irrigated with drug solutions siphoned off from a jar into a dropper obtained from a disposable hemotransfusion system. Patients on active drainage avoided complications, 47 of them were successfully operated on the urethra, in 55 urethral competence recovered without surgical interventions.