Urethral trauma. Part I: introduction, history, anatomy, pathology, assessment and emergency management

Any type of trauma may affect any part of the urethra but much the commonest is iatrogenic trauma due to catheterisation, instrumentation or surgery of the urethra. Catheterisation alone accounts for ≈3.2 urethral injuries per 1000 hospital patients [1]. Other than surgery, e.g. injuries to the distal penile urethra during circumcision or hypospadias repair or to the posterior urethra during excision of the rectum or the treatment of prostate cancer, most iatrogenic injuries affect the bulbar urethra. Such injuries are generally minor, isolated, recognised at the time and managed by urethral or suprapubic catheterisation (SPC) or both, according to circumstances; and recovery is to be expected although a stricture may develop. © 2011 BJU INTERNATIONAL.