Urology: posterior urethral injury in pelvic fracture: practice question

A General Surgery question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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General Surgery · Urology: posterior urethral injury in pelvic fracture

Sample item

After a road traffic accident with pelvic fracture, a man has blood at the meatus, inability to void and a high-riding prostate. What should be done initially?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

C. Suprapubic catheter and delayed urethroplasty after about 3 months

Blood at the meatus after pelvic fracture suggests posterior urethral injury, and a urethral catheter should not be passed blindly because it may convert a partial tear to a complete one. Suprapubic drainage with delayed repair allows haematoma resolution, and a retrograde urethrogram defines the injury.

Option by option

  • A. Immediate forceful urethral catheterisation

    Blind catheterisation can worsen the injury.

  • B. Discharge with observation

    Retention needs drainage.

  • C. Suprapubic catheter and delayed urethroplasty after about 3 months (correct)

    Correct. Suprapubic diversion with delayed repair is standard.

  • D. Immediate primary urethral anastomosis in all cases

    Early primary repair in a bleeding pelvis is hazardous.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

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Questions about this General Surgery question

What is the answer to this General Surgery question?

The best answer is C, Suprapubic catheter and delayed urethroplasty after about 3 months. Blood at the meatus after pelvic fracture suggests posterior urethral injury, and a urethral catheter should not be passed blindly because it may convert a partial tear to a complete one.

Why is "Immediate forceful urethral catheterisation" not the answer?

Blind catheterisation can worsen the injury.

Why is "Discharge with observation" not the answer?

Retention needs drainage.

Why is "Immediate primary urethral anastomosis in all cases" not the answer?

Early primary repair in a bleeding pelvis is hazardous.

What concept does this question test?

It tests Urology: posterior urethral injury in pelvic fracture in General Surgery. Suprapubic drainage with delayed repair allows haematoma resolution, and a retrograde urethrogram defines the injury.

How hard is this question?

We tag it as a multi-step question: it asks you to combine more than one idea. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Urology: posterior urethral injury in pelvic fracture?

Learn classic signs and eponyms alongside what they diagnose. Then use the flashcards and the other General Surgery questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.