URINARY Section 12: Urethra Flashcards
2 parts of the male urethra.
Anterio and posterior
The anterior part of the male urethra is made up of
Penile urethra + bulbar urethra
The posterior part of the male urethra is made up of
Membranous + prostatic urethra
The most anterior porstion of the male urthra is termed
Fossa navicularis
an ovoid mound that lies in the posterior wall of the prostatic urethra.
Verumontanum
embryologic “mullerian” remnant)
prostatic utricle
center of teh veumontanum
Retrograde study fills what part of the male urethra?
Anterior part
Anterograde study fills what part of the male urethra?
Posterior part
There are two methods for identifying the bulbar-membranous junction
- Find the cone shaped appearance of the bulbar urethra
- draw a line connecting the inferior marins of the obturato foramina
Trauma + Blood in the meatus = Next step?
RUG (retrograde urography)
Straddle injury
Crashed your bicycle
Anterior injury
but is often associated with various juggling, fire eating, and sword swallowing injury patterns - as well as mania, and histrionic personality disorder.
Pelvic fracture and bladder injury.
Crashed your Ferrary
Posterior injury
I speculate that crashing one’s Ferrari is also associated with sudden and severe atrophy of the penis.
Type 1 Urethral injury
Posterior + “Stretched” + Intact urethra noramla on RUG
Type 2 Urethral injury
Posterior + Membranous urethra + tear + Above and INTACT UG Diaphragm
+ Extreperitoneal contrast + Incontinence
Type 3 Urethral injury
Bulbar + Membranous (ant + post) + UG Diaphragm ruptured
+ Extraperitoneal contrast
+ Perineaal contraast
+ Scrotal contrast
+ Incontinence
Type 4 Urethral injury
Posterior + Bladder base + prostatic urethra
+ incontinence
Type 5 Urethral injury
anteior + Bulbous urethra
Straddle injury
The most common external cause of traumatic stricture
Straddle injury
compression of the urethra against the inferior edge of the pubic symphysis.
Straddle injury
What urethra is affected in straddle injury?
Bulbuous urethra
long irregular stricture
Gonococcal Urethral Stricture
pancreatic enzymes jacking the urethra.
PAncreatic transplant urethral injury
This has been known to cause urethral injury, if the drainage is to the bladder (the old way of doing it).
Multiple small filling defects seen on a RUG should make you think this.
Condyloma Acuminatum
Urethrorectal Fistula occurs when?
post radiation
Classically described in brachytherapy
esult of long term foley placement.
Urethral Diverticulum
Malignant tumors of the male urethra are rare. When they do occur, 80% are
Squamous cell tumors
exception (prostatic urethra has TCC 90% of the time)
Cancer in a urethral diverticulum is nearly ALWAYS
Adenocarcinoma (rather than squamous cell)
Female + repeated UTI =
Urethral diverticulum
Urethral diverticulum
Posterolateral wall M/3
Female urethral diverticulum often coexists with
stress ureinary incontinence (60%) and UTI
“Saddle-bagg” configuration
Female urethral diverticulum
What could develop within a urethral diverticulum in females?
stones = infection = irrittion = inc cancer risct = ADENOCA (60%)
