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Straddle Injury: Trauma of the Anterior Urethra

The most common injuries of the anterior urethra are caused by a blunt trauma of the perineum (straddle injury) or by transurethral manipulation (Machtens et al., 2000).

Signs and Symptoms of an Anterior Urethral Injury

• Bloody discharge from the meatus
• Hematuria
• A Hematoma is normally confined to the perineum and penile shaft. If Buck fascia is torn, the hematoma can extend into the scrotum.
• Urinary extravasation and phlegmone
• Urethral stricture: may become symptomatic up to 10 years later.

Diagnostic Workup

Treatment of an Anterior Urethral Injury

Insert a transurethral indwelling catheter with the help of fluoroscopy or after insertion of a guide wire, if necessary. The catheter is removed after 7–14 days, depending on the severity of the injury. In severe cases and if a transurethral catheter alignment is not possible, a suprapubic cystostomy is the treatment of choice. After removal of the catheter, further treatment depends on the extent and location of the urethral stricture.

References

  Deutsche Version: Verletzung der vorderen Harnröhre