injuries poisoning
Urethral Trauma
Key Points
Most posterior urethral injuries are associated with pelvic fractures. Anterior injuries are usually from a blunt mechanism; urethral injuries with penile fractures or from penetrating trauma occur less frequently. Consider urethral injuries particularly in patients who have pelvic fractures or straddle injuries and who have blood at the urethral meatus or difficulty voiding. In males, do retrograde urethrography before urethral catheterization. In females, do cystoscopy and a thorough vaginal examination. Treat contusions with urethral catheterization and most urethral disruptions initially with a suprapubic cystostomy; consider primary realignment in select cases. Delay surgical reconstruction except in select injuries (ie, penile fractures, penetrating injuries, and female urethral injuries). 