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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
- 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 WorkupRetrograde urethrogram
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.
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ReferencesMachtens u.a. 2000 MACHTENS, S.. ; STIEF, C. G. ; HAGEMANN, J. ; PFINGST, G. ; GäNSSLEN, A. ; POHLEMANN, T. ; TRUSS, M. C. ; KUCZYK, M. A. ; BECKER, A. J. ; JONAS, U.: Management traumatischer Läsionen von Harnblase und Urethra.
In: Urologe B
40 (2000), S. 560–571
Deutsche Version: Verletzung der vorderen Harnröhre