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[Surgical treatment of urethral stricture. 5th report: Incontinence after urethroplasty for posterior urethral stenosis due to pelvic fracture].

During the past 20 years' period, 35 cases with posterior urethral stenosis following pelvic fracture got surgical repair at the St. Marianna University School of Medicine. The surgical methods were pull through method in 30 cases and Michalowski method in 5 cases. We noted postoperative incontinence in 2 cases (5. 7%) which was attributable to previous surgery at other hospitals. Another one case had incontinence due to trauma itself. As Turner-Warwick has stressed, although the external sphincter muscle is damaged at the time of posterior urethral injury, the internal sphincter muscle is well preserved. In order to protect internal sphincteric function, immediate reconstruction of the posterior urethra after trauma especially by the interlocking method should be avoided and temporary cystostomy is recommended. Cystography at rest through a cystostomy tube before final reconstructive surgery can confirm patency of the internal sphincter muscce. Urinary incontinence after surgery can be avoided by careful dissection of the scar, leaving soft healthy tissue