Open (outdoor) trauma of the urethra

Open (outdoor) trauma of the urethra in wartime is observed frequently, accounting for 30-40% of all injuries urinary system; frequency rank first gunshot wounds posterior urethra, the second - bolotnogo, the third - hanging Department of the urethra.
In most cases, open wounds urethra combined with damage to nearby structures of the pelvis, rectum, bladder, prostate, of the scrotum, cavernous phone
Symptoms of open wounds of the urethra similar to the symptoms of closed injuries.
However, unlike the closed damage to the urethra, which initially are aseptic and infected only in the future in connection with urinary zachecamy, open damage from the moment of its occurrence are infected.
With extensive defect hanging of the urethra carries urine may be entirely allocated through him, and the proximal hole peripheral segment on the border with the wound can obliteriruta.
When open wounds bolotnoe part of the urethra, urinary retention is observed in about half of cases, and in others it is released through the hole or partly through the wound, partly through the outer opening of the urethra.
Injured Department of the urethra are accompanied, as a rule, urinary retention, not only from mechanical reasons, but also from spasm of the sphincter. Wounds in the posterior urethra are often combined with wounds rectum. Urine and feces, getting into the wound channel, can cause the development of cellulitis, persistent fecal and urinary fistulas, pyelonephritis and apostatizing jade.
Treatment. Primary wound treatment is required. Discharge of urine and further treatment are the same as in closed injuries of the urethra. Hematomas opened, urinary leakages drain. While wounding vnebrachnogo Department rectum widely open wound and expose the damaged area. If this does not create a sufficiently favorable conditions for discharge of Cala, you have to apply artificial anus.