Fractures: urethral injury in pelvic fracture: practice question

A Orthopaedics 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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Orthopaedics · Fractures: urethral injury in pelvic fracture

Sample item

A man with a pelvic fracture has blood at the external urethral meatus and a high-riding prostate. What is the next step?

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

The answer and the reasoning

B. Retrograde urethrogram before any catheterisation

Blood at the meatus after pelvic trauma suggests urethral injury, typically of the posterior (membranoprostatic) urethra. A retrograde urethrogram confirms it, and a catheter should not be passed blindly because it can convert a partial tear into a complete one.

Option by option

  • A. Immediate Foley catheter insertion

    Blind catheterisation can worsen the injury.

  • B. Retrograde urethrogram before any catheterisation (correct)

    Correct. Image the urethra first with a retrograde urethrogram.

  • C. Per rectal digital massage

    Rectal massage has no role and can cause harm.

  • D. Intravenous urography only

    IV urography does not evaluate the urethra adequately.

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 Orthopaedics question

What is the answer to this Orthopaedics question?

The best answer is B, Retrograde urethrogram before any catheterisation. Blood at the meatus after pelvic trauma suggests urethral injury, typically of the posterior (membranoprostatic) urethra.

Why is "Immediate Foley catheter insertion" not the answer?

Blind catheterisation can worsen the injury.

Why is "Per rectal digital massage" not the answer?

Rectal massage has no role and can cause harm.

Why is "Intravenous urography only" not the answer?

IV urography does not evaluate the urethra adequately.

What concept does this question test?

It tests Fractures: urethral injury in pelvic fracture in Orthopaedics. A retrograde urethrogram confirms it, and a catheter should not be passed blindly because it can convert a partial tear into a complete one.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. 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 Fractures: urethral injury in pelvic fracture?

Pair each fracture with its classic complication and nerve injured. Then use the flashcards and the other Orthopaedics 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.