Trans-abdominal Approach for Pelvic Fracture Urethral Injuries

Pelvic fracture urethral injuries (PFUIs) occur in approximately 10% of pelvic fracture cases [1, 2]. The majority of PFUIs are simple and can be approached successfully through the perineum, with reported success rates between 85% and 97% [3]. However, a small subset of patients has complex PFUIs that require a combined abdomino-perineal approach for adequate exposure and repair [4, 5]. The abdomino-perineal approach was first described by Pierce in 1962 and subsequently modified by Waterhouse and Turner-Warwick to reduce morbidity associated with complete pubectomy [6]. In this chapter, we describe the abdominal approach for PFUI repair in male and female patients.