Urethral trauma

Introduction to urethral trauma Male urethra is divided into anterior and posterior urethra. The anterior urethral trauma is mostly in the urethral tract of the ball, and the posterior urethral trauma is mostly in the urethra of the membrane. The urethra of the penis is more active due to less activity and less trauma. The female urethra is short and straight because of its low chance of injury. Male urethral trauma is a common urinary trauma in peacetime. Can be divided into closed injury and open injury. basic knowledge Sickness ratio: 0.1% Susceptible people: no special people Mode of infection: non-infectious Complications: urethral stricture, urinary retention, urinary fistula

Urethral traumatic cause

Perineal straddle injury (10%):

Posterior urethral injury (8%):

Open urethral injury (15%):

Iatrogenic injury (10%):

First, closed injury:

(1) Ball urethral trauma: The perineum rides over a hard object, causing injury to the ball urethra due to the compression of the pubic arch and hard objects.

(2) Membrane urethral trauma: violent pelvic fractures, fractures of the urethra or fractures of the fractures can cause urethral trauma, and the sites are in the urethra of the membrane.

(3) intraurethral trauma: mostly for iatrogenic injury, various urethral instruments such as urethral probes, metal catheters, cystoscopy or transurethral resectoscope, ureteroscopy, etc., improper use of patients, foreign body or urethra error Corrosive drugs can damage the urethra.

Second, open injuries:

Seen in the wartime when the firearms were injured, the blade was injured or the human and animal bite, and the firearm wounds were accompanied by combined injuries.

Urethral trauma can be divided into contusion, partial fracture and complete fracture according to the degree of injury.

Urethral trauma prevention

1, pay attention to rest, high nutrition diet.

2, pay attention to hygiene, prevent infection, prevent acne from occurring in patients who have been lying for a long time.

3. It is very important to prevent the early treatment of urethral stricture. To achieve a satisfactory end-to-end anastomosis, the anastomosis should be wide, control the infection after surgery, and then do regular urine dilatation.

Urethral trauma complications Complications, urethral stricture, urinary retention, urinary retention

After urethral trauma, due to improper treatment or serious infection, it often causes urethral stricture, which occurs earlier, most of which have symptoms within three months, severe cases can cause complete urinary retention, urethral stricture often accompanied by chronic infection or inflammation around the urethra , abscess around the urethra and urinary fistula.

Urethral trauma symptoms Common symptoms The urethra mouth is funnel-like change urethral mucosa valgus urethra diffuse infiltration edema urinary extravasation urinary tract urinary bifurcation urethral bleeding shock

1. Shock: The urethral injury of the ball is generally not accompanied by shock. The urethral trauma of the membrane is accompanied by a pelvic fracture, and the amount of bleeding is high. About half of the wounded have shock.

2. Urethral bleeding: After the injury, the blood flows out from the outer urethra, and has nothing to do with urinating. The urethral or completely broken wound of the membrane has less chance of bleeding through the external urethra.

3. Urinary dysfunction: due to pain and sphincter spasm, bladder sensation and urinary sensation, can not discharge urine.

4. Extravasation of urine.

Urethral trauma examination

Anal finger examination can find that the anterior wall of the rectum is full and has a sense of fluctuating. If it is a complete fracture, the prostate can float or shift.

X-ray examination: plain film can diagnose pelvic fracture, and urethral angiography is injected into the urethral orifice. It can be seen that the contrast agent overflows from the damaged area, so that the damaged part and the extravasation of urine can be known.

Diagnostic catheterization: The catheter is blocked at the injury and a small amount of blood is discharged. When the fracture is partially broken, the catheter can be slightly blocked, but it can still be placed, and the anterior segment of hematuria appears and the posterior segment is clear urine. The catheter can be introduced into the bladder and left unattended as one of the treatment measures for urethral trauma.

Diagnosis of urethral trauma

Pelvic fracture can cause urethral trauma of the membrane can also cause extraperitoneal rupture of the bladder. It should be noted that after the rupture of the bladder, there is no self-bleeding of the external urethra; the bladder in the suprapubic region is not filled with swelling; the catheter is inserted smoothly but No urine flow; anal finger prostate position is normal, no floating upshift phenomenon, urethral injury is opposite to the above points, but if both are traumatized, the diagnosis is difficult, difficult to judge or identify, often by surgical exploration Confirmed diagnosis.

The material in this site is intended to be of general informational use and is not intended to constitute medical advice, probable diagnosis, or recommended treatments.