Indications for retrograde cystourethrography in trauma.

Injuries to the lower genitourinary tract may occur with penetrating or severe blunt lower abdominal trauma. Commonly associated findings are pelvic fractures and gross hematuria or a bloody urethral discharge. Retrograde cystourethrography should be performed in all cases of penetrating trauma when lower genitourinary tract injury is suspected. We recommend retrograde urethrography in male patients with a pelvic fracture or significant lower abdominal or perineal trauma without a fracture when associated with gross hematuria, a bloody urethral discharge, inability to void, swelling, ecchymosis or hematoma of the perineum or penis, or a "high-riding" or boggy prostate. Cystography should follow urethrography after a urethral injury has been excluded.