Extravasation of urine
Superficial
extravasation is likely with complete rupture of the bulbar urethra and in ruptured
urethral abscess.
The extravasated urine is confined in front of the midperineal point by the attachment
of Colles fascia to the triangular ligament, and by the attachment of Scarpa’s
fascia just below the inguinal ligament. The
external spermatic fascia stops it getting into the inguinal canals.
Extravasated urine collects in the scrotum and penis and beneath the deep layer
of superficial fascia in the abdominal wall.
Treatment is by urgent operation to drain the bladder by suprapubic cystostomy.
This prevents further extravasation.
Deep extravasation (Fig. 67.7) occurs with extraperitoneal rupture of the bladder or
intrapelvic rupture of the urethra. It can also occur if the ureter is damaged
or if there is perforation of the prostatic capsule or bladder during transurethral
resection. Urine extravasates in the layers of the pelvic fascia and the
retroperitoneal tissues.
Treatment is by suprapubic cytostomy and drainage of the retropubic space.