Clinical Presentation & Protocol
Patient Usually Complains Of
Patient presents following [straddle-type/penetrating/iatrogenic] trauma to the perineum. Reports acute onset of urethrorrhagia, inability to void, and perineal pain. Denies history of prior urethral stricture or instrumentation. Associated symptoms include perineal hematoma and localized swelling.
Clinical Examination Findings
Physical examination reveals blood at the external urethral meatus. Perineal inspection shows [butterfly-shaped hematoma/ecchymosis/swelling]. Digital rectal examination performed to assess prostate position (normal/stable). Abdominal exam is soft, non-tender, with no evidence of bladder distension or guarding.
Treatment Protocol
Immediate management includes stabilization and avoidance of blind catheterization. Retrograde urethrography (RGU) ordered to delineate injury site. If partial disruption is confirmed, suprapubic cystostomy or gentle primary realignment may be indicated. Prophylactic broad-spectrum antibiotics initiated. Surgical consultation for definitive repair pending imaging results.