Diagnosis

Urine extravasation in the field denotes lower urinary tract injury, and localization of the site becomes imperative. Injection of methylene blue through a feeding tube inserted into the urethral meatus, next to the urethral catheter, will show the site of injury. Urethroscopy will help to diagnose and test the integrity of the repair. Unrecognized injuries may have different presentations postopera-tively. Fistula formation is the most common presentation. A retrograde urethrogram and, if possible, a voiding cys-tourethrogram will show the site and the extent of injury (complete vs incomplete). Intravenous pyelogram with a voiding film should be obtained. Urine analysis and culture should be obtained.

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