A 30-year-old man sustains a straddle injury while falling astride a bicycle frame. There is blood at the external urethral meatus and a high-riding prostate on per rectal examination. Which investigation should be performed before attempting urinary catheterisation?
- A CT cystography
- B Intravenous urography
- C Retrograde urethrography ✓
- D Ultrasound KUB
Correct answer: C. Retrograde urethrography
Explanation
Blood at the meatus and a high-riding prostate are classic signs of posterior urethral disruption. Retrograde urethrography is the investigation of choice and must precede any catheter attempt, because blind catheterisation can convert a partial tear into complete transection. CT cystography assesses the bladder after urethral integrity is established, so it cannot be the first step here.
Reference: Bailey and Love's Short Practice of Surgery, 27th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.