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

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