[Lesions of the male urethra]

In cases where there is clinical suspicion of urethral lesion, blind urethral catheterization should never be performed. Establishment of a suprapubic catheter is a safe and adequate primary treatment. Retrograde urethrography may be undertaken in the subsequent diagnostic process and, in cases of simple contusions without interruption of continuity, urethral catheterization is performed. In addition, intravenous urography should be undertaken to reveal possible simultaneous lesions of the upper urinary tract. Anterior lesions rarely require further treatment whereas posterior lesions with interruption of continuity should be treated in specialized departments with special expertise in this type of lesion. Partial ruptures frequently heal without stricture formation requiring treatment. In cases of complete rupture, the best results, as regards development of late sequelae, are obtained by delayed reconstruction carried out three to four months after the trauma in the form of a two-stage operation employing a perineal skin-flap and secondary reanastomosis. In all types of urethral lesion, control miction-cystourethrography is recommended one year after the final treatment on account of the risk of stricture formation.