Goldman classification of urethral injuries

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The Goldman classification of urethral injuries is a more widely accepted classification than one proposed by the American Association for the Surgery of Trauma (AAST). The Goldman classification is based on the anatomical location of the urethral injury and was initially proposed by Colapinto and McCallum but later modified to include type IV, IVa and V injuries.

Classification

  • type I: stretching of the posterior urethra due to disruption of puboprostatic ligaments, though the urethra is intact
  • type II: posterior urethral injury above urogenital diaphragm
  • type III: injury to the membranous urethra, extending into the proximal bulbous urethra (i.e. with laceration of the urogenital diaphragm)
  • type IV: bladder base injury involving bladder neck extending into the proximal urethra
    • internal sphincter is injured, hence the potential for incontinence
  • type IVa: bladder base injury, not involving bladder neck (cannot be differentiated from type IV radiologically)
  • type V: anterior urethral injury (isolated)