Partial inferior pubectomy in the delayed repair of pelvic fracture urethral injury: adopting bone-nibbling technique

Ikenna Ifeanyi Nnabugwu1,2, Fredrick Obiefuna Ugwumba1,2, Anthony Alex Ilukwe2

1 Department of Surgery, College of Medicine, University of Nigeria Enugu Campus

Enugu, Nigeria.

2 Department of Surgery, University of Nigeria Teaching Hospital, Ituku-Ozalla, PMB 01129

Enugu, Nigeria.

Correspondence to:

Ikenna Ifeanyi Nnabugwu, Department of Surgery, College of Medicine, University of Nigeria Enugu Campus, Enugu, Nigeria.



Background: Deployment of wedge inferior pubectomy could be challenging to many urethral surgeons. Objectives: To introduce bone-nibbling technique in accomplishing partial inferior pubectomy (PIP) in a resource-poor setting. And to report medium- to long-term outcome of using the technique. Methods: Five patients (mean age: 38.8years) who presented, over a period of 30 months, with posterior urethral fibrosis from pelvic fracture urethral injury (PFUI) were recruited. One had failed previous attempt at posterior urethral reconstruction elsewhere. The length of urethral defect was from 2 – 4cm. Bone-nibbling technique used in deploying partial inferior pubectomy for delayed repair of PFUI in these patients is described. In addition, the outcomes in the medium to long term of surgical procedures done with this technique are presented. Results: Immediate post-op complications in all were essentially Clavien-Dindo grade I. Peak flowrate assessed 12weeks post-op was between 20ml/s and 23ml/s (mean: 21ml/s). The longest duration of follow-up was 34months and all patients were voiding satisfactorily. Conclusions: Satisfactory and durable outcome can be obtained from nibbling off bits of bone from inferior margin of pubic bone in accomplishing PIP. This is of interest to lower urinary tract reconstructive surgeons who have concerns with chiseling-out wedge of inferior pubis.

Keywords: Bone nibbling; Partial inferior pubectomy; PFUI; Posterior urethra; Urethral anastomosis..

Ann Afr Surg. ****; **(*):***


Conflicts of Interest: None

Funding: None

© 2020 Author. This work is licensed under the Creative Commons Attribution 4.0 International License.


The Annals of African Surgery is the official publication of the Surgical Society of Kenya.


All content copyright © 2021 Annals of African Surgery.

ISSN (print): 1999-9674; ISSN (online): 2523-0816

Main Office Location: Menelik Medical Centre, Menelik Road, off Ngong Road, Nairobi. First floor.

Telephone: +254715260499



The content on this site is intended for health professionals. Advertisements on this site do not constitute a guarantee or endorsement by the journal, Association, or publisher of the quality or value of such product or of the claims made for it by its manufacturer.

Click here to subscribe and get the latest from Annals of African Surgery

  • Twitter
  • Facebook Social Icon
  • YouTube
  • LinkedIn
  • Instagram