Objective:To search for a safe and convenient surgical method

urethral realignment

for management of bulbous urethral disruption.Methods:Cystoscopy was used to bypass the ruptured segment by introducing a guide-wire through its channel to the bladder without water injection or low pressure water injection

and then a silicone catheter(F18) was sent into bladder passed over the guide wire.Results:Urethral realignment was accomplished successfully in 21 of 23 cases.8 cases underwent no water injection and 13 cases underwent low pressure water injection under direct viewing.Open surgery was necessitated in 2 cases.Effusion developed in 4 cases

3 in scrotum and perineum

1 in scrotum

perineum and pelvic cavity.Urine flowed fluently after catheter was removed at 3～4 weeks after operation.Routine postoperative urethral dilation was performed on 6 patients.Strictures developed in 3 cases

2 of which underwent internalurethrotomy and 1 underwent anastomosis.Conclusion:Urethral realignment with the urethral guidance by cystoscopy without water or with low pressure water injection is a safe

mini-invasive and effective surgical strategy for the management of bulbous urethral disruption.