urethrales Trauma

Teenager in

an MVA with pelvic pain and vaginal bleeding. Axial CT with contrast of the lower pelvis (above left) shows a contrast-fluid level in the bladder in the anterior part of the pelvis along with a fluid-filled vagina in the middle of the pelvis that lies anterior to the rectum. There is also free fluid noted around the bladder. At a lower level in the CT (below left) the left wall of the vagina is seen to be completely disrupted and discontinuous. AP image from the voiding phase of a voiding cystourethrogram exam obtained a month later (right) shows contrast leaking out of the left side of the urethra.The diagnosis was vaginal laceration with associated urethral laceration.

pediatricimaging.org • CC-by-nc-sa 4.0

Teenager with

pelvic fracture from trauma who cannot void. AP (upper left) and oblique (upper right) images from a voiding cystourethrogram with the bladder filled through a suprapubic catheter shows extravasation of contrast into the base of the penis when the patient attempts to void. Oblique image from a retrograde urethrogram (below) shows an inability to fill the urethra completely during retrograde injection.The diagnosis was urethral transection confirmed at cystoscopy.

pediatricimaging.org • CC-by-nc-sa 4.0

Teenager with

enuresis. Transverse US of the prostatic urethra (upper left) shows a small round echogenic lesion with posterior shadowing in the center of the prostatic urethra which was not seen in the transverse US of the penile urethra (upper right). Sagittal US of the bladder (lower left) shows an echogenic lesion with posterior shadowing in the posterior aspect of the bladder that on transverse US of the bladder (lower right) resolved into two separate echogenic lesions with posterior shadowing.The diagnosis was urethral trauma due to a metal axle from a toy car the patient had inserted into his urethra years before which had perforated the bladder creating a colovesical fistula and caused development of two bladder stones.

pediatricimaging.org • CC-by-nc-sa 4.0