Posterior pelvic fracture urethral distraction defect (PFUDD) is a tricky urologic problem that can results some complications, like urinary incontinence, incapability to void due to recurrent stricture that will leads to a lifelong disabling condition. The risk factors of urethral injury all along with concomitant pelvic fracture are caused by some factors like the sex, age, and the kind of pelvic fracture. This is a damage to urethra where because of fracture in pelvic bone the two ends of urethra get incise and go away from each other and this was a complex condition. It may be linked with rectal injury. Finest treatment includes Supra Catheter and operation. As the understanding of the disease process has enhanced with development of better imaging by the form of magnetic resonance imaging (MRI) and Doppler ultrasound and with improved surgical techniques, the success rates of posterior anastomotic urethroplasty also improved worldwide.
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The principles in the surgical treatment of posterior urethral distraction defect may includes complete removal of scar tissue linking the membranoprostatic region, lateral fixation of pliable prostatic mucosa, and formation of a tension-free mucosa to mucosa anastomosis.
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This may be accomplished by perineal method in many cases, with abdominoperineal method being necessary only for few selective patients.
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The most significant maneuver is to attain tension-free anastomosis is the mobilization of bulbar urethra, which is satisfactory in most of the patients to bridge a gap of 2–3 cm.
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An elaborative perineal method including the separation of supracrural rerouting, corporal bodies, inferior pubectomy of the urethra or a perineoabdominal approach with superior or total pubectomy is necessary in longer defects or complex cases.
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The ultimate use of these methods is to straighten the usually curved course of the urethra and to attain a shorter distance to the prostatic urethra.
