Injury in Pelvic Fracture Urethral Injury Is Membranobulbar: Fact or Myth

Abstract

Pelvic fracture urethral injuries commonly result from motor vehicle collisions, and the mechanism of injury conventionally thought was a shearing injury at the membranous urethra, which would destroy the striated sphincter. Continence would therefore depend on the bladder neck. Striated sphincter and the site of injury have not been shown clearly on preoperative imaging. We demonstrate our protocol of performing magnetic resonance imaging whereby the membranous sphincter is seen intact and the injury is shown to be at the membranobulbar junction contrary to conventional belief. This suggests that surgical reconstruction can be undertaken, preserving both sphincter mechanisms and improving postoperative continence.