Following urethral rupture, immediate procedure to be done is: September 2008, March 2009
**Core Concept**
Urethral rupture is a serious urological emergency that requires immediate management to prevent further complications, such as urinary extravasation, infection, and stricture formation. The goal of initial management is to stabilize the patient, control bleeding, and prevent infection.
**Why the Correct Answer is Right**
The immediate procedure to be done following urethral rupture is retrograde urethrogram (RUG) and urinary catheterization under fluoroscopic guidance. This allows for the assessment of urethral integrity, identification of any urethral injuries, and potential placement of a catheter to drain the bladder. **Retrograde urethrogram** helps to visualize the urethra and identify any extravasation of urine, which can guide further management. **Urinary catheterization under fluoroscopic guidance** enables the placement of a catheter in a controlled manner, reducing the risk of further injury to the urethra.
**Why Each Wrong Option is Incorrect**
**Option A:** This option is not relevant to the immediate management of urethral rupture. **Option B:** Immediate surgical repair is not typically performed as the first step in managing urethral rupture. **Option D:** This option does not address the need for a diagnostic procedure to assess urethral integrity.
**Clinical Pearl / High-Yield Fact**
In the setting of urethral rupture, it's essential to avoid attempting to pass a catheter without imaging guidance, as this can exacerbate the injury and lead to further complications.
**Correct Answer: C. Retrograde urethrogram and urinary catheterization under fluoroscopic guidance.**