Urethral trauma refers to a serious injury that damages or tears the urethra, the soft muscle tube that carries urine from the bladder to the genitals. Traumatic injuries are much more common in men than in women, as the male urethra is less protected and much longer. A person might experience difficulties urinating, pain and swelling in the groin, and blood in the urine. It is important to visit a doctor when urethral trauma is suspected to receive a thorough exam and learn about different treatment options. Most mild injuries heal with medications and rest, but serious trauma often requires surgery to repair tissue and prevent future complications.
The male urethra is approximately 6 to 8 inches (about 15.25 to 20.3 centimeters) long. It is well protected near the bladder, but comes close to the skin's surface at the perineum, the area between the genitals and tailbone. The urethra then extends through the penis, where it is also highly susceptible to injury. The female urethra is surrounded by muscle, fat, and bone tissue through most of its 1.57-inch (about 4-centimeter) course from the bladder to the vagina.
Most cases of female urethral trauma and a percentage of male incidences result from straddle injuries. Straddle injuries occur when excessive pressure is placed on the perineum, as can happen by falling on a fence or sitting down too hard on a bicycle seat. Male urethral trauma can also occur with blunt force to the penis that causes it to stretch or bend too much. In addition, some cases of both male and female urethral trauma accompany pelvic fractures suffered in major car accidents or very bad falls.
A person who has suffered urethral trauma may experience a number of symptoms. The most common problem, especially in males, is a weakened urine stream and increased frequency of urination. A person may experience pain or burning sensations when urinating, and he or she may also notice traces of blood in the stream. Pain, redness, and swelling of the perineum or genitals may also be present.
A urologist or emergency room doctor can usually diagnose urethral trauma by asking about causative accidents and inspecting the site of the injury. Blood and urine samples are collected and analyzed to check for bacterial infections. X-rays and endoscopic exams are typically not needed, but a doctor may decide to use them to confirm a diagnosis.
Treatment for minor cases of urethral trauma involves resting and icing the painful area, taking anti-inflammatory drugs, and scheduling checkups with a urologist. If the urethra is significantly damaged, an endoscopic surgical procedure can be considered. A surgeon can drain the bladder with a catheter and then realign and suture torn tissue. In the case of pelvic fractures, several additional reconstructive surgeries may be needed.