traumas were identified in 20 cases based on CT images indicative of pelvic fractures, and the patients were then treated with urethral catheterization.
It has been reported that utilization of suprapubic cystoscopy in urethroplasty gives the surgeon an opportunity to inspect the proximal end of the stricture, providing the advantage of being able to avoid causing a false-passage or mal-alignment during the anastomosis (12), (13) By using suprapubic cystoscopy, the anatomic integrity of the bladder neck can easily be visualized, and when advanced to the membranous urethra
after passage through the prostatic urethra, the obliterated end of the proximal urethra can be visualized.
In traumatic urethral strictures, bulbar urethra was the most common site in 63% of the patients followed by membranous urethra
and penile urethra in 20% and 10% of patients respectively.
In type I, the urogenital diaphragm is dislocated and the membranous urethra
is stretched; in type II, the membranous urethra
is ruptured above the urogenital diaphragm at the apex of the prostate; and in type III, the membranous urethra
is ruptured above and below the urogenital diaphragm, causing a complete disruption.
This unique feature protects the entire urethra from trauma; especially the membranous urethra
, which is most susceptible to stricture and where lubricant can not reach.
This provides temporary, effective local anesthesia to the distal urethra and typically to the membranous urethra
and bladder neck.
However, exposure of the bulbar and membranous urethra
Video urodynamic studies reveal unstable detrusor contractions and narrowing of the membranous urethra
. This patient's headaches are likely symptoms of: