Urethral injuries after pelvic trauma: evaluation with urethrography

Area of Science:

• Radiology
• Trauma Surgery
• Urology

Background:

• Urethral injury is a frequent complication of pelvic trauma.
• Undiagnosed injuries can lead to significant long-term morbidity.
• The urethra near pubic rami and puboprostatic ligaments is highly vulnerable.

Purpose of the Study:

• To emphasize the importance of complete urethral imaging in pelvic trauma patients.
• To highlight the challenges in performing urethrography in trauma settings.
• To discuss methods for overcoming imaging difficulties and ensuring accurate diagnosis.

Main Methods:

• Computed tomography (CT) is often used for initial polytrauma evaluation.
• Urethrography is the preferred method for assessing and classifying urethral injuries.
• Special techniques may be required to obtain optimal images despite patient immobility or presence of surgical devices.

Main Results:

• Complete urethral imaging is vital at presentation to avoid exacerbating injuries with catheterization.
• Urethrography can be challenging post-pelvic trauma due to patient immobility or indwelling devices.
• Various methods exist to ensure accurate urethrographic diagnosis in difficult cases.

Conclusions:

• Accurate and timely diagnosis of urethral injury is essential to prevent long-term complications.
• Urethrography is superior to CT for detailed urethral assessment after pelvic trauma.
• Radiologists must employ specific techniques to overcome challenges in imaging immobile or device-dependent patients.