Significant extraperitoneal bladder rupture associated with pelvic fracture requiring treatment by external fixation
Significant extraperitoneal bladder rupture with extravasation of contrast agent into the scrotum
Intraperitoneal bladder rupture
Significant extraperitoneal bladder rupture that has not healed after 3 weeks of Foley catheter drainage
Significant extraperitoneal bladder rupture with gross hematuria
CT cystography is best performed with undiluted contrast medium.
If the patient is already undergoing computed tomography (CT) for evaluation of associated injuries, CT cystography should be performed via antegrade filling of the bladder after intravenous administration of radiographic contrast material and clamping the Foley catheter.
An absolute indication for immediate cystography is the presence of pelvic fracture and microhematuria.
If plain film cystograms are obtained, the study is considered negative and complete if there is no extravasation of contrast agent seen on the filling film.
None of the above
They are present in 90% of patients presenting with pelvic fractures.
They are associated with microhematuria or no hematuria in 40% of cases.
High mortality rate is primarily related to nonurologic comorbidities.
Extraperitoneal ruptures are always amenable to nonoperative treatment.
They coexist with urethral disruption in 50% of cases.
associated urethral injury.
associated rectal injury.
all of the above.
associated vaginal injury.
associated orthopedic injury.
Orthopedic hardware in the pubic symphysis area is a contraindication to open posterior urethroplasty.
The patient is at high risk for incontinence after posterior urethral reconstruction surgery.
One-stage, open, perineal anastomotic urethroplasty is preferred.
Buccal mucosa graft urethroplasty is recommended.
UroLume stent placement is recommended.
CT of abdomen and pelvis
None of the above
Filiforms and followers
Ultrasonography of the penis
Exploration of the penile corpora through a midline scrotal incision
Magnetic resonance imaging of the penis
Exploration of the penile corpora through a circumcision incision
Left testicular reconstruction with synthetic graft
Immediate primary repair of the left testis
Application of wet dressings and delayed testicular surgery
Closure of the scrotal laceration followed by ultrasonography
Urethral catheterization alone
Spatulated, stented, tension-free, watertight repair of the urethra with absorbable sutures
Suprapubic tube placement
Buccal mucosa graft urethroplasty
Rupture of a superficial vein can sometimes mimic the presentation of a corporeal tear.
Patients with penile fracture who are treated nonoperatively are more likely to have longer hospital stays, a higher risk of infection, and penile curvature than those whose fracture is repaired surgically.
Physical examination is usually sufficient in making the diagnosis or for deciding on surgical exploration.
Most injuries occur ventrolaterally.
Retrograde urethrography should be uniformly performed to assess for urethral injury.
has a degree of hematoma that correlates with the extent of injury.
is often diagnosed by the presence of intratesticular hypoechoic areas on ultrasonography.
is usually a bilateral process.
requires conservative management that results in acceptable viability and function.
is definitively diagnosed during physical examination alone in most cases.
The severed phallus should be placed directly on ice during transport.
Primary macroscopic reanastomosis invariably results in erectile dysfunction.
Microscopic reanastomosis of the corporeal arteries is recommended.
Skin loss is rarely a problem after macroscopic repair.
Microscopic dorsal vascular and neural reanastomosis is the best method of repair.
Foreskin flap for small distal lesions
Meshed skin graft in a young child
Burying the penile shaft in a scrotal skin tunnel
an opportunity for controlled antegrade urethral realignment.
inspection of bladder.
not jeopardizing continence or potency rates.
allowance for large-bore catheter insertion.
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