You are here: Urology Textbook > Urethra > Straddle injury

Straddle Injury: Trauma of the Anterior Urethra

The most common injuries of the anterior urethra are caused by a blunt trauma of the perineum (straddle injury) or by transurethral manipulation (Machtens et al., 2000).

Signs and Symptoms of an Anterior Urethral Injury

• Bloody discharge from the meatus
• Hematuria
• Hematoma (within Colles' fascia: scrotum, perineum, and penis)
• Urinary extravasation and phlegmon
• Urethral strictures may become symptomatic even many years later.

Diagnostic Workup

Treatment of an Anterior Urethral Injury

Most blunt injuries can be treated by insertion of a transurethral catheter, using a guide wire, or fluoroscopy if difficult. Urethral exposure and suturing of the injury is necessary for penetrating injuries, which may also involve the corpora cavernosa; see section penile injury. Removing the catheter is possible after 7–14 days, depending on the severity of the injury. A second-look urethrography after catheter removal is done for more extensive repairs. Further treatment is necessary if a urethral stricture develops.