Urine extravasations occur in following cases of penile urethral rupture (AIIMS May 2011)
|D||Below superficial fascia of penis|
c. Although a suprapubic tube provides effective urinary drainage without risking further disruption of the urethra, a urethral Foley should be placed across the injury when possible.
d. If the disruption is only partial, this can be accomplished by placing a guidewire into the bladder by using a flexible cystoscope, or even a flexible ureteroscope, and placing a catheter over the wire.
e. If complete urethral disruption is present, two flexible cystoscopes, inserted through the meatus as well as through a suprapubic cystostomy, can be used to align the urethra.
f. Early urethral alignment can often obviate the need for formal, surgical repair of the urethra.
g. If a completely disrupted urethra cannot be aligned, a definitive repair should be performed in 4 to 6 months.
b. Anterior urethral traumas are usually isolated injuries that most commonly result from a straddle injury.
c. Anterior urethral injury can also occur as a result of direct trauma to the penis.
d. Pelvic fractures are rare in patients with anterior urethral injuries.
e. More distal injuries are contained by Buck's fascia and resulting hematomas dissect along the penile shaft .
f. More proximal injuries to the anterior urethra may be contained by Colles' fascia and produce a perineal hematoma.