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19 year old man presents after an unfortunate incident in a martial arts tournament
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Posterior Urethra Tear

  • Exam demonstrates extravasation of contrast material into the perineum from the prostatic urethra. There is also a tear of the bulbar urthra
  • Type 3 tear is likely most common injury in patients with urethral transection resulting from pelvic fracture 

Urethral Injuries

Types result from complex trauma with pelvic fractures:

  • Type 1: urethra intact but narrowed, stretched by periurethral hematoma or partial tear.
  • Type 2: Rupture above urogenital diaphragm
  • Type 3: Rupture above and below Urogenital Diaphragm

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Retrograde Urethrogram

  • Posterior Urethra = prostatic + membranous portions
  • Anterior Urethra = bulbous and penile portions
  • Verumontanum: dorsal elevation inprostatic urethra that receives paired ejaculatory ducts and the utricle
  • Membranous Urethra demarcates urogenital diaphragm; radiographically defined as the portion between the distal verumontanum and the cone of the bulbous urethra
  • Cowper glands are in the urogenital diaphragm; ducts empty into proximal bulbous urethra
  • Littre glands are in the anterior urethra
  • Utricle: Mullerian duct remnant. Blind ending pouch in the midline
  • Fossa Navicularis: 1-cm long dilatation of distal anterior urethra

 Example of partial tear of the anterior Urethra
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These signals are relayed buying clomid online safe which then is by a number of such as medial preoptic and paraventricular nulcei.