Urethral Trauma

Abstract

Traumatic urethral injuries are most frequently a result of blunt trauma. Anterior urethral injures typically result from straddle-type injuries or penile fractures, while posterior urethral injuries are nearly always associated with pelvic fractures. A urethral injury is suggested by mechanism of injury or blood per urethra, and the diagnosis is confirmed by retrograde urethrography.Acute management in both anterior and posterior urethral injuries centers on securing adequate drainage of the bladder. This may be achieved with a urethral catheter alone in partial urethral injuries; however, complete urethral disruptions require suprapubic cystostomy. Anterior urethral lacerations may be best repaired acutely in some circumstances, although this is almost never the case with posterior urethral injuries. Primary urethral realignment over a catheter may be a reasonable option if heroic efforts are not necessary, but this alone rarely prevents urethral stenosis. Stricture or stenosis of the urethra may result from the traumatic injury, and this is best treated in a delayed fashion after the full extent of the injury is known and other associated injuries have been treated.KeywordsBladder NeckPelvic FractureUrethral InjuryCorpus SpongiosumAnterior UrethraThese keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.