Urethral Injuries

The urethra is a tube that connects the bladder to the genitals to remove urine out of the body.

If the urethra is injured, a person may develop urethra obstructions or strictures. Urethral strictures occur when the urethra is injured or scarred by an infection and then narrows. As a result, problems with the normal passage of urine and semen can develop.

Urethral injuries can result in devastating long term consequences. To a young person, the potential complications of impotence, stricture and incontinence often create life-long morbidity.

Injuries affect two parts of the urethra: either the anterior or posterior. In most cases, anterior urethral trauma is characterized as a blunt injury to the perineum, since the urethra is located near the skin in this area. This type of trauma is often the result of straddle-like injuries, such as when a child forcefully straddles a bicycle or fence. Penetrating injuries to the anterior urethra, such as those from a gunshot wound, also may cause strictures or obstructions.

Posterior urethral trauma affects the part of the urethra that travels inside the body. In many cases, this type of trauma almost always occurs as a result of pelvic fractures following automobile accidents, serious falls or industrial crash injuries.

Patients with urethral injuries may experience a variety of symptoms, including:

  • Weak or slow urine stream
  • Dribbling
  • Urinary frequency
  • Urgency to urinate
  • Nocturia, a condition in which a person has to urinate frequently during the nighttime
  • Urinary retention

Management and treatment of urethral injuries can be complex and depends on the severity and location of injury, the patient’s health and whether any other injuries are present. In some cases, emergency surgical repair is recommended, but should be limited to select cases.

Initial suprapubic cystostomy, which involves placing a catheter in the bladder through the lower abdomen, is the safest and simplest treatment option.

Once the urethra has begun to heal, your doctor will reassess your injury and develop a definitive treatment plan. Reconstructive surgery or the placement of a urethral or suprapubic catheter, which is a tube inserted into the bladder to help drain urine, may be recommended.