Which diagnostic test should be used to evaluate urethral injury in penile fracture?

Which diagnostic test should be used to evaluate urethral injury in penile fracture?

• A. Retrograde Urethrogram
• B. Urinalysis
• C. Pelvic Ultrasound
• D. Penile Doppler

Answer: (A)

When a penile fracture raises concern for urethral injury, the key is to directly assess the urethral lumen for rupture or leakage. A retrograde urethrogram does exactly that: contrast is injected into the distal urethra and X-ray imaging shows whether the contrast stays within the urethral tract or extravasates outside it. This tells you if the urethra is intact or ruptured, where the injury is, and how severe it is, which is essential for planning management. If the urethra is intact, catheterization can be performed safely; if there is rupture, catheterization may worsen injury and a different approach, such as suprapubic drainage, may be required. Urinalysis cannot determine urethral continuity and may only show blood without localizing injury. Pelvic ultrasound and penile Doppler provide information about surrounding structures or blood flow but do not reliably evaluate urethral integrity. So the retrograde urethrogram is the best test to evaluate urethral injury in the setting of penile fracture.

When a penile fracture raises concern for urethral injury, the key is to directly assess the urethral lumen for rupture or leakage. A retrograde urethrogram does exactly that: contrast is injected into the distal urethra and X-ray imaging shows whether the contrast stays within the urethral tract or extravasates outside it. This tells you if the urethra is intact or ruptured, where the injury is, and how severe it is, which is essential for planning management. If the urethra is intact, catheterization can be performed safely; if there is rupture, catheterization may worsen injury and a different approach, such as suprapubic drainage, may be required. Urinalysis cannot determine urethral continuity and may only show blood without localizing injury. Pelvic ultrasound and penile Doppler provide information about surrounding structures or blood flow but do not reliably evaluate urethral integrity. So the retrograde urethrogram is the best test to evaluate urethral injury in the setting of penile fracture.