role of an urgent urethrography in the diagnosis and optimal management of anterior urethral injury

Twenty one patients with straddle injuries [thier age ranged from 20- 45 years] underwent urgent urethrography for evaluation of urethral integrity, complete rupture bulbous urethra in 15 patients and simple urethral contusion in other 6 patients. 10 patients were managed by primary urethral reconstruction with supra pubic diversion and the other 5 patients by supra pubic cystostomy as the primary repair for rupture bulbous urethra. Two out of ten patients were managed by primary urethral reconstruction requires further procedure of urethral dilatation, while 3 patients were managed primarily by suprapubic cystostomy required gradual urethral dilatation, two of them visualised internal uretherotomy and only one patient needs surgical excision of strictured part with urethroplasty [end to end anastomosis]. Therefore urgernt urethrography provides, non invasive, simple and accurate diagnostic procedure for the extent of urethral injury, that is necessary for optimal management with the best successful outcome and least morbidity, as well it can eliminate the controversy existed about the result of primary urethral repair in comparison to suprapubic cystostomy as preliminary procedure as it clarifies the extent of urethral injury