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The diagnosis of acute urethral trauma Full Text
Injury, 08/29/2011
Luckhoff C et al. – Reliance on clinical features alone to predict urethral injury results in a substantial proportion of missed injuries in major trauma patients. Retrograde urethrograms (RUG) did not appear to be needed in patients with no disruption of the pubic symphysis on initial pelvis X–ray or where no signs of urethral injury are present. In the absence of clinical signs and pubic symphysis disruption, blind urethral catheterisation may be attempted.
Methods- A retrospective review of adult major trauma patients diagnosed with urethral injuries during an 8–year period at a major trauma centre, was conducted.
- There were 998 major trauma patients with fractures of the pelvis over the study period, of whom 223 had pubic symphysis disruption.
- There were 29 patients with urethral injuries.
- The sensitivity of any one of the traditional signs of urethral trauma was 66.7% (95% CI: 46.0–82.8).
- After exclusion of patients with penetrating trauma and iatrogenic injuries, pubic symphysis disruption on initial pelvis AP X–ray and/or the clinical signs of urethral injury had a sensitivity of 100% (95% CI: 84.4–100.0) for urethral trauma.