- 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 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
- Anterior urethra:
- Injuries are rare
- Urethral injuries are classified as follows:
- 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
- Rare with pelvic fractures
- Straddle injuries
- Childbirth or vaginal surgery
- Sexual trauma/abuse
- More common with pelvic fractures
- More common with straddle injuries
- Penetrating trauma, mutilation
- Sexual activity/instrumentation
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Schaider, Jeffrey J., 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: Schaider JJJ, Barkin RMR, Hayden SRS, et al, eds. 5-Minute Emergency Consult. Lippincott Williams & Wilkins; 2016. https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307263/all/Urethral_Trauma. Accessed June 5, 2023.
Urethral Trauma. (2016). In Schaider, J. J., Barkin, R. M., Hayden, S. R., Wolfe, R. E., Barkin, A. Z., Shayne, P., & Rosen, P. (Eds.), 5-Minute Emergency Consult (5th ed.). Lippincott Williams & Wilkins. https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307263/all/Urethral_Trauma
Urethral Trauma [Internet]. In: Schaider JJJ, Barkin RMR, Hayden SRS, Wolfe RER, Barkin AZA, Shayne PP, Rosen PP, editors. 5-Minute Emergency Consult. Lippincott Williams & Wilkins; 2016. [cited 2023 June 05]. 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 - Barkin,Adam Z, ED - Shayne,Philip, ED - Rosen,Peter, ED - Schaider,Jeffrey J, ED - Barkin,Roger M, ED - Hayden,Stephen R, ED - Wolfe,Richard E, 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 -