الفهرس 
ANATOMY OF THE PENIS AND MALE PERINEUMOnly 14 pages are availabe for public view
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Abstract
Urethral injuries, by themselves, are never life-threatening, except as a consequence of their close association with pelvic fractures and multiple organ injuries, which occur in about 27% of cases. Initially, the assessment and management of other associated injuries are usually far more important than the assessment and management of the urethral injury (Chapple and Prig, 1999).
The male urethra is divided into the anterior and posterior sections by the urogenital diaphragm. The posterior urethra consists of the prostatic and the membranous urethra. The anterior urethra consists of the bulbar and penile urethra (Chapple and Prig, 1999).
The antero-posterior and lateral compression types of fracture, while vastly different, may be associated with both stable and unstable subtypes. The vertical shear fracture is always unstable; the latter, described by Malgaigne in 1855, consists of a fracture anteriorly through both rami of the symphysis pubis, in association with massive posterior disruption, either through the sacrum, the sacro-ili accurate diagnosis of urethral injury is difficult, and there may be no convincing differences on urethrography between partial and complete transactions. A partial disruption is noted when contrast material is seen to extravasate at the site of injury and at least a portion of it also passes through the prostatic urethra and into the bladder. Complete disruption demonstrates extravasation at the site of injury onlyac joint or the ilium (Pokorny et al., 1979).
When the urethra is ruptured, blood is present at the urethral meatus in the majority of patients. Other signs of urethral injury may include a patient’s inability or difficulty with voiding; non palpable, distended bladder; or the inability to pass a urinary catheter into the bladder (Moudouni et al., 2001 & Morey and Rozanski, 2007).
Retrograde urethrography is considered to be the best initial study for urethral and periurethral imaging in men and is indicated in the evaluation of urethral injuries, strictures, and fistulas (Akira et al., 2004).
Posterior urethral injuries were managed by early intervention to realign or repair the urethra and drain the pelvic hematoma. This approach was associated with an unacceptably high rate of impotence and incontinence, so a shift toward a more conservative approach using immediate suprapubic catheter drainage followed by delayed urethroplasty . With the recent advances in endoscopic techniques and the realization that, in general, the magnitude of the injury rather than the initial management is responsible for the impotence and incontinence, the approach to managing these injuries is again mired in controversy (Webster et al., 1985).