[Concomitant rupture of bladder and posterior urethra in fracture of pelvis, analysis of 36 cases].

Among 2120 patients with fracture of pelvis, 36 (1.6%) had simultaneous rupture of bladder and posterior urethra. Of the 36 patients 34 were male and 2 female and the ratio of male to female was 17:1. This urological injury is rare and is often misdiagnosed. The following conditions are typical: (1) anuria after pelvic fracture associated with injured urethra or multiple organic trauma; (2) no fullness of bladder for 4 hours after pelvic fracture with urethral injury (except shock or ARF); (3) bloody urinary fluid in peritoneocentesis or increased urea nitrogen in blood (except shock or ARF). Heavy dose IVP could confirm the diagnosis. The principal treatment included repair of ruptured bladder, suprapubic cystostomy, drainage of urinary extravasation, traction of traumatic posterior urethra, reduction and immobilization of pelvic fracture. In this series, all the patients obtained satisfactory results except one who died of serious traumatic shock.