Injury Mechanism and Urethral Damage
A fall astride a penetrating object causes a direct impact to the perineum. This mechanism is known as a straddle injury.
Identifying the Injured Structure
The bulbar urethra, located in the bulb of the penis, is the most frequently injured part of the male urethra in straddle injuries due to its exposed position and mobility.
Symptom Correlation
- Bleeding from the urinary meatus indicates damage to the urethra.
- Retention of urine occurs because the urethral disruption or associated swelling/hematoma obstructs urine flow.
- Perineal hematoma forms as blood from the ruptured urethra dissects into the surrounding perineal tissues.
Why Option B is Correct
The combination of a straddle injury mechanism and the specific symptoms (meatal bleeding, urinary retention, perineal hematoma) strongly points towards a rupture of the bulbar urethra. This is the classic presentation.
Evaluating Other Options
- Rupture of membranous urethra is less common with direct straddle injuries and more often associated with pelvic fractures.
- Bladder rupture (both intraperitoneal and extraperitoneal) typically presents with more severe signs like suprapubic pain, abdominal distension, and possibly haemoperitoneum, although it can co-exist with urethral injury. However, the primary symptoms here are more indicative of urethral damage.
Important Questions from Urinary System & Surgical Disorders
Which of the following statements are correct regarding renal cell carcinoma?
1. It arises from the epithelium of the proximal convoluted tubule.
2. It has a female preponderance.
3. Major subtypes are clear cell, papillary and chromophobe.
4. Surgery is the mainstay of treatment for disease. organ-confined
Select the answer using the code given below.
Which of the following are features of autosomal dominant polycystic kidney disease?
1. Cyst may also occur in liver, pancreas and arachnoid membrane.
2. Most commonly manifests between 20-30 years of age.
3. Clinical manifestations are renal and extrarenal.
4. Men tend to progress to renal failure more rapidly than women.
Select the correct answer using the code given below.
- Extracorporal Shock Wave Lithotripsy (ESWL) is most commonly used for the treatment of
Which of the following are correct regarding pathology of stress urinary incontinence?
1. Hypermobility of urethra
2. Ascend of bladder neck and proximal urethra above diaphragm
3. Lowered urethral pressure
4. Increased detrusor activity
Select the answer using the code given below.
Which of the following are correct about ectopic ureters ?
1. They are more common in males
2. They drain the upper pole of kidney
3. They are associated with duplex ureter
4. They may cause incontinence
Select the correct answer using the code given below :
