The main manifestations of urethral injury

The human urethra is used to excrete urine. If the urethra is damaged, people will not be able to excrete urine normally, so it will have a great impact on the human endocrine system. If the toxins in the human body cannot be excreted, they will accumulate in the body and cause more diseases. Therefore, if the human urethra is damaged, it must be treated in time. Next, let’s take a look at the main manifestations of urethral injury.

1. What is urethral injury?

The urethra is the most vulnerable part of the urinary system. It mainly occurs in young and middle-aged men. There are very few women, accounting for only 3%. The male urethra is divided into anterior and posterior parts by the genital diaphragm. The anterior urethra, also known as the cavernous urethra, is more susceptible to damage, especially to the bulbous part, which is mainly caused by straddle injuries. The posterior urethra is located in the pelvic cavity and is mainly caused by pelvic fractures. Pathologically, it can be divided into contusion, partial laceration and major or complete rupture. If urethral injury is not treated promptly or is treated improperly, it can easily lead to urethral stenosis and poor urine flow, resulting in serious consequences.

2. Common causes of urethral injury

1. Anterior urethra injury, often seen in straddle injuries, with the injury occurring in the bulbar urethra;

2. Posterior urethra injury is often caused by pelvic fracture, which causes urethral rupture and may be injured at the same time as the bladder.

Symptoms of urethral injury

1. Shock. The incidence of shock after urethral injury following pelvic fracture is high, about 40%, while simple straddle injury generally does not cause shock.

2. Urethra bleeding. Anterior urethral injury may cause blood to drip or overflow from the urethral opening.

3. Pain. There is often local pain and tenderness, pain during urination, and radiation to the glans penis and perineum.

4. Difficulty urinating and urinary retention. Those with severe injuries are unable to urinate immediately after the injury, and a swollen bladder can be felt in the suprapubic area a while after the injury.

5. Hematoma and ecchymosis Ecchymosis and hematoma can be seen under the skin of the straddle injury, and may extend to the perineum, causing the skin of the scrotum and perineum to swell and become bluish purple.

6. Urine extravasation. Whether urine extravasation occurs and the location of urine extravasation after urethral injury depends on the degree and location of urethral injury. Urine extravasation often occurs in patients with urethral rupture or breakage and frequent urination. Urine extravasation around the bladder may cause rectal irritation signs and lower abdominal peritoneal irritation signs. If urine extravasation is not treated in time or secondary infection occurs, it can lead to tissue necrosis and suppuration. In severe cases, symptoms of systemic poisoning may occur. Local infection or necrosis may form urinary fistula.

4. Diagnosis of urethral injury

Based on medical history, symptoms and signs, the diagnosis of urethral injury is not difficult. The signs of anterior urethral injury are generally more obvious and easier to diagnose, while the diagnosis of posterior urethral injury is more difficult.

The diagnosis of urethral injury should be based on the history of trauma, symptoms and signs, and attention should be paid to the following issues:

1. Determine the site of urethral injury.

2. Estimate the extent of urethral injury.

3. Check for any combined injuries to other organs. Patients with urethral injury after pelvic fracture caused by severe trauma, especially those in shock, should be carefully checked for any injuries to other organs to avoid missing life-threatening injuries to important tissues and organs.