Anterior bladder wall
Answer B) Bulbous urethra
This man straddled an object and struck the genital area when he fell, which is known as a straddle injury. Damage to urinary structures occurs when soft tissues are crushed between the pelvic bone (pubic symphysis) and the straddled object.
The bulbous urethra lies in close proximity to the pubic symphysis, is relatively immobile, and lacks the protection of the corpora cavernosa.
As a result, it is the most commonly injured structure in men with straddle injuries or direct trauma (e.g., receiving a direct blow or kick) to the male perineum. This patient’s findings of blood at the urethral meatus, perineal ecchymosis, and a scrotal hematoma are classic findings of urethral injury.
When a urethral injury is suspected, a retrograde urethrogram should be obtained before placement of a Foley catheter. If the bladder needs to be urgently drained before imaging, a suprapubic catheter can be placed.