Anterior urethral trauma: role of sonourethrography

We present a case of blunt anterior urethral trauma during sexual activity in a 20-year-old man. The patient had abundant urethrorrhagia, but there were no obvious clinical data to help locate the urethral lesion. Diagnosis was established by sonourethrography (SUG), which showed a coagulum in the urethral lumen from a small haematoma in the corpus spongiosum of the proximal pendulous urethra. No lesion was observed in the sonography performed previously without urethral distension or in the retrograde urethrography performed afterwards. The utility of SUG for early diagnosis of urethral contusion is analysed, and a novel technique for performing SUG is described. We believe that this procedure should be used routinely in the initial management of patients suspected with lesions of the anterior urethra.