Male Urethral Abnormalities - ARTICLE (HIGH-YIELD - 2 Test Questions!)

Male urethra total length

16-20 cm

Male urethra divisions

Posterior urethra (prostatic + membranous) and Anterior urethra (bulbar + penile)

Prostatic urethra length

~3.5 cm

Prostatic urethra passage

Passes through prostate

Verumontanum

1 cm ovoid mound in prostatic urethra

Membranous urethra length

1-2 cm

Membranous urethra feature

Narrowest part

Membranous urethra passage

Passes through urogenital diaphragm

External urethral sphincter location

In urogenital diaphragm

Bulbar urethra feature

Upward bend at penoscrotal junction

Bulbar urethra shape

Natural cone shape at bulbomembranous junction

Penile (pendulous) urethra

Extends to external meatus

Fossa navicularis

Slight widening at most distal portion

Littre glands

Periurethral glands secreting mucous

RUG best for

Anterior urethra

VCUG best for

Posterior urethra

RUG indications

Blood at meatus, strictures, trauma, fistulas

VCUG indications

Reflux, bladder morphology, incontinence, post-op assessment

RUG patient position

35-45 degree RPO position

RUG position confirmation

Closed right obturator foramen confirms proper position

RUG contrast tip location

In fossa navicularis

RUG contrast amount

20-30 mL hand inject

Urethral stricture cause - infection

Infection/inflammation (gonococcal/nongonococcal urethritis)

Urethral stricture cause - BXO

Balanitis xerotica obliterans (lichen sclerosus)

Urethral stricture cause - trauma

Trauma (straddle injuries most common)

Urethral stricture cause - iatrogenic

Iatrogenic (up to 45% of strictures)

Urethral stricture cause - cancer

Cancer (rare, 1% of urological tumors)

Goldman Type I

Stretched urethra, intact continuity

Goldman Type II

Tear above urogenital diaphragm

Goldman Type III

Most common - extends into bulbar urethra

Goldman Type IV

Bladder base injury involving bladder neck

Goldman Type IVa

Bladder base injury NOT involving bladder neck

Goldman Type V

Anterior urethra injury (straddle)