Urethral transection


Urethral transection is a complication of injuries to the pelvis, including pelvic fractures, straddle injuries, or, in this case, a shotgun wound.

If this patient had shown up in the emergency department, it is clear that trying to immediately place a Foley catheter before attempting a RUG would have had the disasterous consequence of creating a false channel with the catheter and causing even more damage that was already there.

The most common site of traumatic injury of the posterior urethra is at the bulbomembranous junction, where a shear force can occur in a pelvic fracture between the more mobile bulbar urethra and the more rigid membranous urethra. In the case of a gunshot wound, however... the injury can be anywhere.