A number of clinical findings can help identify a male who should be evaluated for a possible urethral injury following trauma.
Risk based on nature of traumatic injury:
(1) blunt or penetrating trauma to the perineum
(2) fracture of the bony pelvis
Symptoms:
(1) inability to void
(2) voiding without passing urine
Signs:
(1) blood at the urethral meatus
(2) ecchymosis of the glans penis, scrotum or perineum
(3) prostate located higher than normal ("high riding")
(4) gross or microscopic hematuria
(5) palpable hematoma on rectal exam
A patient with features suggestive of urethral injury should undergo an imaging study to identify the severity of the injury.
A urethral catheter should not be passed until injury to the urethra has been excluded.
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Specialty: Surgery, orthopedic, Emergency Medicine, Critical Care, Surgery, general, Urology
ICD-10: ,
