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Traumatic urethral injury — ABEM Board MCQ

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ModerateTraumaTraumatic urethral injuryABEM Board

A 30-year-old man arrives after straddling a metal beam. Triage acuity is ESI 3; BP 128/78 mm Hg, HR 92/min. He has perineal ecchymosis, inability to void, and blood at the urethral meatus. The bladder is distended on bedside ultrasound. Which of the following is the most appropriate next step in management?

Educational content. Not a substitute for clinical judgement or local policy.

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Correct answer: E — Obtain retrograde urethrography before catheterization

Blood at the meatus and urinary retention after trauma require retrograde urethrography before urethral catheter placement.

Reference: ATLS genitourinary trauma guidance