Julia R. Fielding, M.D. Brigham and Women's Hospital, Harvard Medical School Boston, Massachusetts

27 Year-old Male with Hematuria

This young man had been traversing western Massachusetts on a mountain bike when he swerved and fell. In the emergency room, he was noted to have blood at the urethral meatus and hematuria.

Oblique view from a retrograde urethrogram (Figure 1) performed using a pediatric foley catheter for occlusion demonstrates transection of the bulbar urethra, the so-called straddle injury. This injury is seen following accidents involving fences, boats and bicycles when the male urethra and corpus spongiosum is compressed between a hard object and the inferior aspect of the pubis. Straddle injuries are not associated with pelvic fractures.