Urethral Trauma
Urethral Trauma is a topic covered in the 5-Minute Emergency Consult.
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Basics
Description
Description
- Blood at the urethral meatus, a palpable full bladder, inability to void, and/or gross hematuria are common findings with urethral trauma.
- Found in 14% of pelvic fractures
- High association with bilateral pubic rami fractures (aka, straddle fractures)
- Females: Urethral injuries are rare likely due to short, unexposed, and mobile urethras.
- Girls <17 yr old: Higher injury rate likely from a more flexible pelvic ring
- Bladder neck most commonly injured location.
- Males: The urethra is divided into 2 sections.
- Posterior urethra:
- More commonly injured (∼90%)
- Prostatic portion
- Membranous
- Anterior urethra:
- Injuries are rare
- Bulbar
- Penile
- Posterior urethra injuries comprise up to 90% of trauma:
- Type 1: Urethra stretched but not ruptured
- Type 2: Prostatic/membranous portions disrupted (either partially or completely); urogenital diaphragm intact
- Type 3: Urethral disruption both proximal and distal to the genitourinary diaphragm
Etiology
Etiology
- Females:
- Rare with pelvic fractures
- Straddle injuries
- Childbirth or vaginal surgery
- Sexual trauma/abuse
- Males:
- More common with pelvic fractures
- More common with straddle injuries
- Penetrating trauma, mutilation
- Sexual activity/instrumentation
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Citation
Rosen, Peter, et al., editors. "Urethral Trauma." 5-Minute Emergency Consult, 5th ed., Lippincott Williams & Wilkins, 2016. Emergency Central, emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307263/all/Urethral_Trauma.
Urethral Trauma. In: Rosen P, Shayne P, Barkin AZ, et al, eds. 5-Minute Emergency Consult. 5th ed. Lippincott Williams & Wilkins; 2016. https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307263/all/Urethral_Trauma. Accessed December 9, 2019.
Urethral Trauma. (2016). In Rosen, P., Shayne, P., Barkin, A. Z., Wolfe, R. E., Hayden, S. R., Barkin, R. M., & Schaider, J. J. (Eds.), 5-Minute Emergency Consult. Available from https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307263/all/Urethral_Trauma
Urethral Trauma [Internet]. In: Rosen P, Shayne P, Barkin AZ, Wolfe RE, Hayden SR, Barkin RM, Schaider JJ, editors. 5-Minute Emergency Consult. Lippincott Williams & Wilkins; 2016. [cited 2019 December 09]. Available from: https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307263/all/Urethral_Trauma.
* Article titles in AMA citation format should be in sentence-case
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