Rupture of the urethra in men and women: the symptoms, the consequences
Various injuries perineum provoke a rupture of the urethra, which may be partial or full, and the skin can be damaged. This phenomenon is accompanied by severe pain when attempting to urinate, hematomas and leakage of urine into the surrounding tissue, leading to serious complications. Pathology requires immediate treatment. Depending on the characteristics of the gap, use conservative therapy or surgery.
Regardless of the severity of the pathology, injury to the urethra is impossible to try to treat themselves.
Due to the nature of the physiology damage of the urethra in women is much rarer than in men. Length of the female urethra on average is less than 2 cm, and the male reaches 23 cm, which are more prone to injury. Sharply enough to sit on a hard surface to damage the urethra. This condition is characterized by severe pain, shock. Depending on the type of rupture, bleeding may be absent, and urination is not violated or a violation is not strong. In any case, it is necessary to consult a doctor.
The types of pathology
On the localization of the damage is isolated gap:
- the anterior part of the urethra that passes through penis;
- the rear part of the channel located near majevica.
Depending on the availability of the lumen of the channel between the urethra and neighboring tissues that provide:
- Penetrating injury. The bed of the channel has the messages with the neighboring tissues. This may be:
- gap channel around the entire circumference;
- gap in one place.
- Non-penetrating injuries. Direction of the urethra is not reported with other tissues.
Unlike a complete break
In the complete rupture of the urethra violated the integrity of all layers of the wall of the channel. Attempts painful urination, the urine is disturbed or disappears as the urine falls outside the urethra into the surrounding tissue. The skin may remain intact. This condition requires immediate treatment as it leads to serious complications. Surgical intervention, europlastik.
In this case, the toiling urethra, the wound is formed. More common in women. Accompanied by a hematoma in the absence of medical assistance can develop a complete rupture. Using the catheter is removed, accumulated in the site of the lesion the blood and empty mocevic. Surgical intervention is not required if the patient requested assistance not later than 6-12 hours after the injury.
Rupture of the urethra occurs due to various injuries of the urethra.
The causes of pathology
To break cause trauma to the urethra, which arise in the case of gunshot or stab wounds of the perineum, injuries to the perineum from the impact when falling on a hard surface, animal bite, fracture of the penis or the pelvic bones. Sometimes the man himself inflicts self-damage, for example, during aggressive Masturbation.
Damage to the urethra can cause such medical procedures as:
- Catheterization. In mocevic through the urethra is inserted a tube to drain urine.
- The cystoscopy. Method of diagnosis of the bladder by the introduction into the body through the urethra a thin tube equipped with a camera.
- Probing. A method of treating stricture of the urethra.
The symptoms of rupture of the urethra
With the full gap is observed:
- violation of urination (a distinguishing feature of a complete rupture of the urethra);
- the bleeding from the wound in the urethra (urethrography);
- the formation of a haematoma between the anus and external sphincter of the urethra (the sexual organs);
- severe pain when attempting to urinate, the occurrence of «bursting» sensation.
Incomplete rupture is characterized by a strong urge to urinate that is often repeated. The process of urination is accompanied by severe pain in the urine visible blood. If you suspect a pelvic fracture, you cannot break the bone to avoid displacement of their fragments, as this will significantly worsen the situation and lead to additional violations of the internal organs.
Methods of diagnosis of rupture of the urethra
For proper diagnosis of an important collection of history, updating all of the symptoms and examination of the patient. If the damage of the prostatic and membranous parts of the urethra the patient feels the urge to urinate when the affected mocevic, urine flows spontaneously. During a rectal examination in the area of prostate swelling detected, pointing to the defeat of the urethra. The catheter cannot be placed, as it contributes to the development of complications.
If it is impossible to diagnose based on clinical presentation, conduct urethrography and x-ray with injection of a contrast agent into the urethra. With the help of this kind of research revealed the fracture and characteristics of injury. The data obtained allow accurate diagnosis and to begin surgical treatment without loss of time.
Retrograde urethrography the most informative method of diagnosis of rupture of the urethra.
Methods of treatment for men and women
The method of treatment is chosen depending on the nature of the injury. Consider a number of symptoms, type of lesion (wound, injury), complications of disease, the General condition of the patient. If a person has a traumatic shock, measures are taken to restore its state. In addition, the urine is withdrawn, opened and clean the bruises and streaks of urine in the tissues, restore the integrity and patency of the urethra, treated damaged skin.
Medication damage to the urethra is in the case of a partial lesion of the urethra, and only if, the patient was taken to the hospital no later than 6-12 hours after the onset of rupture. For recovery of urination and rapid healing of the urethra in the absence of contraindications, the patient put the catheter in for at least 2 weeks. The doctor prescribes:
- antibacterial drugs;
- anti-inflammatory medication;
- means to stop the bleeding.
The operational method is used to eliminate any lesions of the urethra, in addition to injuries and partial tears, if bleeding is absent or it is insignificant, and the hematoma did not increase. Surgical method of treatment involves:
- Application cystostomy. In mocevic through puncture of the abdominal wall is introduced a tube for the direct removal of urine without the participation of the urethra.
- Surgery. After 3-8 days after the injury the patient in surgery, which aims to bridge the gap and restore the lumen of the channel.
- Primary plastic surgery. Is only possible if:
- the defeat of the urethra is in front of it (in the penis);
- trauma to the urethra is accompanied by damage of majevica and/or rectum.
Complication of urethral ruptures with timely treatment is the appearance of stricture (decrease in the diameter of the channel) and infection. These complications respond well to treatment and are quickly eliminated. If you refuse to stay in the hospital may occur:
- blood poisoning;
- purulent process in hematomas;
- the absence of urination or incontinence;
- stricture of the urethra;
- opening of the fistula;
To prevent rupture of the urethra, you need to:
- To carry out urological examination and treatment from highly qualified doctors. Not to put yourself in the catheter.
- To avoid situations that could lead to injury of the perineum.
The reason for the defeat of the urethra often does not depend on the patient. Timely treatment for medical help to prevent serious complications that may affect the neighboring organs and tissues. Therefore, in case of injury to the crotch area of any severity should immediately go to the hospital.