Operative note 14 Core

Anterior urethral injury rules

What it does: safe handling of a torn urethra.

Bruise or stretch: catheter 7-10 days.
Suspected full tear: NEVER pass a catheter blind.
Default: supra catheter above the pubis.
Leave it 6 weeks. Then image. Rebuild at 8-12 weeks.
Partial tear? Wire via flexible scope is allowed. Any resistance: stop.
Repair at once only if: stable patient, stab or gunshot wound, alone, or urethra torn with a fractured penis.
Repair: trim, free up, spatulate both ends. (Spatulate = cut open lengthways.) Join with no tension, over an 18Fr catheter.
Catheter out at 2 weeks. Voiding study first.
No grafts in dirty acute wounds.

From the UroRef Operative Quick Guide.