A 25 year old male presents to emergency dept. following a road traffic accident. On examination there is pelvic fracture and blood at urethral meatus. Following are true about pt except -
Ans is (a) anterior urethra is most likely the site of injury The pa of urethra most likely injured in pelvic fracture is membranous urethra (a pa of post. urethra) - Post. Urethra includes -- Prostatic + membranous urethra - Anterior urethra includes -- Bulbar + penile urethra The anterior urethra (paiularly bulbar urethra) is injured due to direct blow to the perineum (straddle injuries*) About other options ? (d) Prostate is displaced superiorly (high lying prostate) in membranous urethral injury due to rupture of puboprostatic fascia. Pelvic hematoma is seen in membranous urethral injuries (Perineal hematoma is seen in bulbar urethral injury) (b) Once an urethral injury is suspected the pt. is instructed not to pass urine and a RGU or ascending urethrogram is performed to assess the injury. (c) Catheterisation is contraindicated and is passed only if the RGU is normal.
Anterior urethra is the most likely site of injury
Retrograde urethrography should be done after the pt is stabilized.
Foley catheter may be carefully passed if the RGU is normal
Rectal examination may reveal a large pelvic hematoma with the prostate displaced superiorly