How is Urethral Trauma Treated?

The treatment for urethral trauma depends on where and how bad the injury is. Many cases of anterior urethral injury need to be fixed right away with surgery.

Minor of these injuries can be treated with a catheter through the urethra into the bladder. This keeps urine from touching the urethra so it can mend. The catheter is often left in place for 14 to 21 days. After that time, an x-ray is taken to see if the injury has healed. If it has healed, the catheter can be taken out in the doctor's office. If the x-ray still shows leaks, the catheter is left in longer.

If serious urethral trauma is seen on the x-ray, a tube is used to carry urine away from the injured area to keep it from leaking. Urine leaking inside the body can cause:

  • Swelling
  • Inflammation
  • Infection
  • Scarring

The treatment of a posterior urethral injury is very complicated. This is because it's almost always seen with other severe injuries. Unfortunately, it means that this problem can't be fixed right away. Most urologists first place a catheter in the bladder at the time of injury and wait for 3 to 6 months. This gives the body time to reabsorb the bleeding from the pelvic fracture. It's also easier to fix the urethra after swelling in the tissues from a pelvic injury has gone down. Most posterior urethral injuries need an operation to connect the 2 torn edges of the urethra. This is most often done through a cut in the perineum.

If the urethra has completely torn away, urine must be drained. This is done with a tube stuck into the bladder through the skin ("suprapubic"). This Foley catheter goes through the skin just above the pubic bone in the lower belly into the bladder. This is most common after severe injuries. The tube can be put in at the time of abdominal surgery for other repairs. Or it can be done through a small puncture. An x-ray can be used to see that the catheter is in the bladder. Your doctor may suggest a procedure to rejoin the torn urethra over a catheter, which may help it heal.