Genitourinary Trauma: The Daily PANCE Blueprint
A 21-year-old male involved in a motor vehicle accident is brought to the ER via EMS. He sustained multiple blunt injuries to the abdomen. During your exam, it is noted that there is blood at the urethral meatus. Which of the following is the most appropriate test?
A. Renal angiogram
B. Retrograde urethrogram
C. Urinalysis and culture
D. CT abdomen/pelvis STAT
E. Pyelogram
Answer and topic summary
The answer is B. Retrograde urethrogram
About 70% of GU trauma cases involve the male external genitalia. Injuries can occur in the setting of blunt or penetrating trauma. Because there is a high chance of urethral injury, most of the time retrograde urethrogram or urethroscopy is recommended (in the setting of trauma to the male external genitalia). Blind catheter passage prior to retrograde urethrogram is unfavorable and not recommended. In general, a retrograde urethrogram is indicated when blood is found at the external urinary meatus (prior to inserting a catheter) in trauma cases.
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