Question

A young male patient with a history of a motor vehicle accident cannot pass urine. Blood is seen at the meatus. What is the most likely site of urethral injury?

• A. Bulbar urethra
• B. Spongy urethra
• C. Membranous urethra
• D. Penile urethra

Answer 1

The Correct Option is C

To determine the most likely site of urethral injury in this case, we need to consider the clinical presentation and the typical sites of injury following trauma.
Clinical Details: The patient is a young male involved in a motor vehicle accident, unable to urinate, with blood present at the meatus. This suggests a significant urethral injury.
Understanding Urethral Anatomy and Injury:

• The urethra in males is divided into anterior and posterior sections. The anterior urethra includes the bulbar and penile (spongy) urethra; the posterior urethra includes the prostatic and membranous urethra.
• In cases of pelvic trauma, such as what might occur during a motor vehicle accident, the posterior urethra is commonly affected, especially the membranous urethra.
• Blood at the meatus and inability to urinate are classic signs of posterior urethral injury, particularly in high-impact, high-velocity accidents.

Conclusion:

• Based on the mechanism of injury and clinical presentation (blood at the meatus, pelvic trauma), the most likely site of urethral injury is the membranous urethra.

Location	Possible Injury
Bulbar Urethra	Less likely in this context
Spongy Urethra	Uncommon in pelvic trauma
Membranous Urethra	Most likely in pelvic fracture cases
Penile Urethra	Unlikely without external penile trauma

Answer: Membranous urethra