About the disease

Urethral rupture is a trauma of the urethra. Urethra is a tube responsible for carrying urine and semen in men and carrying urine in women. Urethra is connected to the bladder and is responsible for transporting urine from the body.  Urethral rupture is more common in men, because the urethra goes through the penis in men, which is more exposed, whereas in women it is located inside the vaginal area.

Overall, urethral rupture can develop as a result of penile injury or fracture of the pelvic girdle. These are the most common causes of urethral rupture. It can also develop as a result of improper catheter insertion which affected the urethra.

In people with urethral rupture urine can leak to other surrounding tissues, which can be dangerous.

The most common cause when a person may develop penile or pelvic floor injury is blunt trauma. Blunt trauma can usually be brought up by motor vehicle accident or severe fall.  Nonetheless, even in such cases people usually suffer from rupture of pelvic floor, as the fall needs to be really strong to affect the urethra as well. Women can develop urethral rupture as a result of penetrating trauma. Also, older people who have weaker pelvic floor are more prone to have rupture or fracture in case of accident, which, subsequently, can affect their urethra as well. According to MedScape, 5%-10% of all pelvic ruptures result in injuries of urethra, so this condition is extremely rare. In some cases urethral rupture can develop as a result of stab wound or gun shot in case the stab or shot were directed directly at the urethra region.

Symptoms

• Sharp pain in the urethra
• Inability to move the pelvic floor freely
• Loss of consciousness because of acute pain
• Severe bleeding
• Paleness
• Nausea

Diagnosis

• During a general examination the doctor in the emergency room will assess the condition of the pelvic floor and penis area in men. They will determine if the penis or any of the pelvic bones is fractured. In women the doctor will examine the vaginal area to determine if there is bleeding.
• Imaging tests, such an X-ray or MRI/CT scan, are used to examine the urethra and determine if it had been ruptured. These imaging tests will determine the exact location of rupture and also its severity.
• An ultrasound can determine if there is an internal bleeding of any organs, which could develop after an accident or trauma.

Treatment

• Laparoscopic surgery is a minimally invasive surgery which uses laparoscopy to repair the rupture and normalize the work of the urethra.
• A drainage may be used in case of internal bleeding or if urine penetrated to surrounding tissues.
• The healing process may take up to 6-12 weeks. During this time a patient may need to have special dressing and also follow all the instructions of the doctor to speed up the recovery.
• For the duration of healing catheter may be used to assist the urination process.

Authors: Dr. Vadim Zhiliuk, Dr. Sergey Pashchenko