Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2023 Feb 13;12(4):1495.
doi: 10.3390/jcm12041495.

Urethral Injuries: Diagnostic and Management Strategies for Critical Care and Trauma Clinicians

Anish B Patel  1 , E Charles Osterberg  1 , Praveen N Satarasinghe  1 , Jessica L Wenzel  1 , Sabah T Akbani  1 , Saad L Sahi  1 , Brent J Emigh  1 , J Stuart Wolf Jr  1 , Carlos V R Brown  1
Affiliations
Review

Urethral Injuries: Diagnostic and Management Strategies for Critical Care and Trauma Clinicians

Anish B Patel et al. J Clin Med. .

Abstract

Urologic trauma is a well-known cause of urethral injury with a range of management recommendations. Retrograde urethrogram remains the preferred initial diagnostic modality to evaluate a suspected urethral injury. The management thereafter varies based on mechanism of injury. Iatrogenic urethral injury is often caused by traumatic catheterization and is best managed by an attempted catheterization performed by an experienced clinician or suprapubic catheter to maximize urinary drainage. Penetrating trauma, most commonly associated with gunshot wounds, can cause either an anterior and/or posterior urethral injury and is best treated with early operative repair. Blunt trauma, most commonly associated with straddle injuries and pelvic fractures, can be treated with either early primary endoscopic realignment or delayed urethroplasty after suprapubic cystostomy. With any of the above injury patterns and treatment options, a well thought out and regimented follow-up with a urologist is of utmost importance for accurate assessment of outcomes and appropriate management of complications.

Keywords: blunt urethral trauma; iatrogenic urethral injury; penetrating urethral injury; urethral injury; urethral trauma.

PubMed Disclaimer

Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Basic urethral anatomy.
Figure 2
Figure 2
RUG indicating urethral injury.
Figure 3
Figure 3
Diagnostic and Treatment Algorithm for Urethral Injury.
See this image and copyright information in PMC

References

    1. Martinez-Pineiro L., Djakovic N., Plas E., Mor Y., Santucci R.A., Serafetinidis E., Turkeri L.N., Hohenfellner M. EAU Guidelines on Urethral Trauma. Eur. Urol. 2010;57:791–803. doi: 10.1016/j.eururo.2010.01.013. - DOI - PubMed
    1. Morey A.F., Brandes S., Dugi D.D., 3rd, Armstrong J.H., Breyer B.N., Broghammer J.A., Erickson B.A., Holzbeierlein J., Hudak S.J., Pruitt J.H., et al. Urotrauma: AUA guideline. J. Urol. 2014;192:327–335. doi: 10.1016/j.juro.2014.05.004. - DOI - PMC - PubMed
    1. Velarde-Ramos L., Gomez-Illanes R., Campos-Juanatey F., Portillo-Martin J.A. Traumatic lesions of the posterior urethra. Actas Urol. Esp. 2016;40:539–548. doi: 10.1016/j.acuro.2016.03.011. - DOI - PubMed
    1. Lim P.H., Chng H.C. Initial management of acute urethral injuries. Br. J. Urol. 1989;64:165–168. doi: 10.1111/j.1464-410X.1989.tb05980.x. - DOI - PubMed
    1. Koraitim M.M. Pelvic fracture urethral injuries: The unresolved controversy. J. Urol. 1999;161:1433–1441. doi: 10.1016/S0022-5347(05)68918-5. - DOI - PubMed

LinkOut - more resources