Traumatic Female Urethral Avulsion Associated with Pelvic Fracture: A Case Report

Traumatic female urethral avulsion is rare and there are no consensus in the management. There is also paucity of report of similar case in tropical Africa. Most cases of female urethral injury are partial tears. Complete female urethral avulsion is uncommon and usually traumatic in origin from road traffic accident or fall from height. We present a 55 year old post-menopausal woman who had a complete circumferential transection of the urethra with extensive posterior and anterior vaginal wall laceration following pelvic fracture and also a left hand injury from a motor vehicular accident. The aim reporting this case is to increase the awareness of traumatic female urethral avulsion injury with pelvic fractures in a poly-traumatized patient post-menopausal female and emphasize the place of immediate primary repair in achieving optimal outcome. The management can be very challenging because the impact can involve the pelvic bone, bladder, vagina and rectum with will invariably increase morbidity and mortality. This patient was managed in a multidisciplinary approach which consisted of primary repair of the urethra and vaginal lacerations as well as repair of the hand injury with conservative management of pelvic fracture. The outcome was favorable and uneventful as the anatomic function of all involved structures were restored.