Extravasation of urine

Urinary tract injuries are more common in men, and are divided into open and closed categories, which are common emergencies in urology. Open urethral injuries are mostly caused by shrapnel and sharp injury, often accompanied by penetrating injuries to the scrotum, penis or perineum. Closed injury is a contusion, laceration, or direct injury to an endoluminal device. Anatomically, the male urethra is divided into anterior and posterior segments by the urogenital diaphragm. The anterior urethra includes the bulb and penis, and the posterior urethra includes the prostate and membrane. Urinary tract injuries occur mostly in the bulb and membrane. Improper treatment early can cause complications such as urethral stricture and urinary fistula. Urinary extravasation after urethral injury: The urethra is the most vulnerable part of the urinary system. It mainly occurs during the young age of men. Women are rare, accounting for only 3%. The male urethra is divided into two parts by the genital ridge. The anterior urethra is the cavernous urethra, especially the ball, which is mainly caused by riding injuries. The posterior urethra is located in the pelvic cavity and is mainly caused by a pelvic fracture. 1. Urinary extravasation of bulbous urethral injury (rupture of penile fascia) 2. Anatomy of normal penis, scrotum, fascia 3. Extravasation of penile urethral injury (intact penile fascia) 4. Extravasation of urethral injury of prostate (1) In the case of anterior urethral injury, if the penile fascia also ruptures, the urine leaks along the penis, scrotum, and superficial fascia below the abdominal wall to the scrotum, penis, superficial perineum, and abdomen. Because the superficial fascia of the abdominal wall is fixed at the inguinal ligament, the urine will not leak to the femurs on both sides. This situation is most common. (2) When the urethral rupture occurs between the posterior urethra, that is, between the two layers of the urogenital diaphragm, or after this, the urine leaks out along the prostatitis to the posterior pubic space and around the bladder. The bladder is mainly fixed to the urogenital diaphragm by the membrane urethra. If the urethra is completely broken, the bladder is often pushed upwards by extravasated blood and urine. Keep a large gap between the two ends of the urethra. If it is not reset and fixed in time in the emergency department, it will inevitably bring difficulties to the later repair. Rupture of the urethra may be accompanied by urethral abscess and urinary fistula. Due to the formation of fibrous scars in the later stage, urethral strictures can occur. (3) When the urethral rupture is before the anterior urethral part before the genitourinary ridge, if the inherent fascia of the penis is still intact, urinary extravasation is limited to the penis.