orifice Urethral Injury Injuries to the male urethra have been traditionally classified into 2 main categories according to their mechanism of injury: 1) those associated with a fracture of the anterior pelvic arch (usually involving the membranous urethra) and 2) those occurring as the result of a straddle injury (usually involving the bulbous urethra); both of these types of male urethral injury are more commonly found after blunt trauma, but can also result from penetrating trauma. The penile urethra is injured less frequently than the bulbar and membranous segments of the urethra overall; however, the penile urethra is more commonly injured with penetrating trauma because of its entirely external location. Female urethral injuries are rare and are usually associated with pelvic fracture or vaginal laceration [2,9,11]. The rarity of female urethral injury is due to the relatively shorter length, internal location posterior to the osseous Discussion of Procedures by Variant Variant 1: Penetrating trauma, lower abdomen and pelvis. Suspected lower urinary tract trauma. Initial imaging. Radiography Pelvis There is no relevant literature regarding the use of radiographs in the evaluation of penetrating trauma to the lower urinary tract. Radiography of the pelvis plays an ancillary role by identifying radiopaque foreign bodies associated with penetrating injuries and in identifying pelvic fractures. Pelvic radiography can be combined with RUG. CT Pelvis with Bladder Contrast (CT Cystography) Schneider [12] stated that either retrograde cystography or CT is the diagnostic procedure of choice for a suspected bladder injury, and Horstman et al [13] found that both types of imaging examinations equally detected all types of bladder injury in blunt trauma patients. The authors indicated that contrast instillation during CT can provide the adequate bladder distention needed to demonstrate contrast extravasation from the injury site.
Penetrating Trauma Lower Abdomen and Pelvis. orifice Urethral Injury Injuries to the male urethra have been traditionally classified into 2 main categories according to their mechanism of injury: 1) those associated with a fracture of the anterior pelvic arch (usually involving the membranous urethra) and 2) those occurring as the result of a straddle injury (usually involving the bulbous urethra); both of these types of male urethral injury are more commonly found after blunt trauma, but can also result from penetrating trauma. The penile urethra is injured less frequently than the bulbar and membranous segments of the urethra overall; however, the penile urethra is more commonly injured with penetrating trauma because of its entirely external location. Female urethral injuries are rare and are usually associated with pelvic fracture or vaginal laceration [2,9,11]. The rarity of female urethral injury is due to the relatively shorter length, internal location posterior to the osseous Discussion of Procedures by Variant Variant 1: Penetrating trauma, lower abdomen and pelvis. Suspected lower urinary tract trauma. Initial imaging. Radiography Pelvis There is no relevant literature regarding the use of radiographs in the evaluation of penetrating trauma to the lower urinary tract. Radiography of the pelvis plays an ancillary role by identifying radiopaque foreign bodies associated with penetrating injuries and in identifying pelvic fractures. Pelvic radiography can be combined with RUG. CT Pelvis with Bladder Contrast (CT Cystography) Schneider [12] stated that either retrograde cystography or CT is the diagnostic procedure of choice for a suspected bladder injury, and Horstman et al [13] found that both types of imaging examinations equally detected all types of bladder injury in blunt trauma patients. The authors indicated that contrast instillation during CT can provide the adequate bladder distention needed to demonstrate contrast extravasation from the injury site.