Lecture notes for medical students

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2. Introduction

3. Introduction
• Rupture urethra can be divided into rupture
of
– bulbous urethra
– Membranous urethra
• Bulbous urethra blow to the perineum Straddle
kicks
• Membranous urethra Fracture pelvis
– RTA
– Fall
• Iatrogenic
• Rare penetrating

4. Relevant Anatomy

5. Relevant Anatomy
Urethra cosists of
• The posterior urethra
• The Anterior urethra

6. Relevant Anatomy
• The posterior urethra includes the prostatic
urethra, which extends from the bladder
neck through the prostate gland.
• It then joins the membranous urethra,
which lies between the prostatic apex and
the perineal membrane.

7. Relevant Anatomy
• The anterior urethra 3 segments.
– The bulbar urethra
– The penile urethra.
– The fossa navicularis is in glans penis.

8. Clinical Features

9. Clinical Features
The signs of a ruptured bulbar urethra are
• retention of urine,
• Perineal haematoma
• bleeding from the external urinary meatus

10. Rupture of the membranous
urethra

11. Rupture of the membranous
urethra
• Intrapelvic rupture of the membranous
urethra occurs near the apex of the prostate .
• Most usually a result of pelvic fracture.
• If the prostate is displaced, it may be out of
reach or ‘high’ on rectal examination.

12. Clinical Features

13. Clinical Features
• Retention urine
• Subcutaneous extravasation of urine

14. Diagnostic Studies

15. Diagnostic Studies
Imaging Studies
• An ascending urethrogram(RGU) with
water-based contrst.

16. Management

17. Management
• Avoid urethral catheterization
• Ascending urethrography
• Suprapubic Cystostomy
• Delayed urethroplasty
• Open repair of penile urethra.

18. Complications

19. Complications
• Stricture
• Urinary incontinence
• Impotence

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