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    Urethral Trauma

    Urethral Trauma is a topic covered in the 5-Minute Emergency Consult.

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    Emergency Central

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    Basics

    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

    • 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 April 23, 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 April 23]. 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
    TY - ELEC T1 - Urethral Trauma ID - 307263 ED - Rosen,Peter, ED - Shayne,Philip, ED - Barkin,Adam Z, ED - Wolfe,Richard E, ED - Hayden,Stephen R, ED - Barkin,Roger M, ED - Schaider,Jeffrey J, BT - 5-Minute Emergency Consult UR - https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307263/all/Urethral_Trauma PB - Lippincott Williams & Wilkins ET - 5 DB - Emergency Central DP - Unbound Medicine ER -