Following trauma, a patient presents with a drop of blood at the tip of urinary meatus. He complains of inability to pass urine. Next step should be -
Blood at the meatus is suspicious of urethral injury and an immediate urethrography is advised to rule out any urethral injury. The cauterization is not done until urethral injury is ruled out. So among the given options in the question, none seems to be correct. But have a look at what Bailey writes - "Very occasionally, if the facilities for passing a percutaneous suprapubic catheter are not available, it may be permissible to try to pass a soft, small caliber urethral catheter without force. This may allow a few patients to avoid the open placement of a suprapubic tube into the bladder." Cambell's Urology advocates a method of treatment as follows: "Incomplete urethral tears are best treated by stenting with a urethral catheter. We and others have not seen any evidence that this can conve an incomplete into a complete transaction, as was suggested in groundbreaking repo by Mitchell and we usually make one gentle attempt to place a urethral catheter in suspected paial disruption." This catheter is kept in place for 6 weeks. This allows time for injury to heal without need for an operation. Ref : Bailey & Love 25/e p1360
IVP should be done
MCU should be done
Catheterise, drain bladder, and remove the catheter therafter.
Catheterise, drain bladder and retain the catheter therafter.
Urology