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Trauma and injury to the urethra
Last reviewed: 05.07.2025
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[ Causes of trauma and damage to the urethra
Penetrating, isolated injuries to the urethra are less common and may result from the insertion of objects into the urethra due to sexual activity or mental illness.
Urethral injuries include contusions, partial or complete ruptures, which are anterior and posterior. Posterior urethral ruptures usually occur with pelvic bone fractures, anterior ones - as a result of perineal injuries. Penetrating and iatrogenic urethral injuries are also divided into anterior and posterior. Complications of urethral injuries include strictures, infections, erectile dysfunction, and urinary incontinence.
Symptoms of Urethral Trauma and Damage
The most important sign of damage to the urethra is the appearance of blood from its mouth. Additional symptoms include bruising and swelling in the perineum and scrotum. Retrograde urethrography confirms the diagnosis. It is not recommended to perform urethral catheterization before urethrography.
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Treatment of trauma and damage to the urethra
The contusion can be safely treated with transurethral catheterization for 10 days. In partial rupture, a suprapubic cystostomy is best; however, in some cases of posterior partial rupture, an attempt at primary catheterization of the urethra is acceptable.
In case of a complete rupture, a suprapubic epicystostomy is indicated. This is the simplest choice, safe for all patients. Reconstructive surgery is postponed for up to 3 months from the moment of injury, after the formation of a scar and the patient's recovery from combined injuries.