Bladder neck disruption

Urethral injuries may be iatrogenic (Fig. 25.13) or inflicted. Bladder neck disruption seems to... 

The radiologist should avoid any urethral catheterization when urethral disruption is suspected. Secondary repair is the rule for urethral injuries, so that a minimal imaging evaluation should be performed in emergency situations (Baskin and McAninch 1993). Retrograde opacification of the urethra by water-soluble iodinated contrast medium is the reference examination (Fig. 25.15). A Foley catheter with a balloon inflated in the fossa navicu-laris is used. CT cystography can be considered in cases of bladder neck disruption and/or pelvic bones fractures. 

Fig. 25.14a,b. Bladder neck disruption in a young boy who underwent blunt abdominal trauma. Intravenous urography. Plain film (a) showed traumatic widening of the pubic symphysis, (b) As soon as 5 min, the faintly opacified urinary bladder (B) appears elevated by an infravesical leak (arrows)... 

This is an unusual drug in that it contains a metal atom, platinum (Pt) in this case. Cisplatin reacts with DNA to cross-link bases, disrupting normal DNA structure and function. This agent has found broad use in cancer chemotherapy, including efficacy in tumors of the testis, ovary, bladder, head and neck, thyroid, cervix, and endometrium. It is also active against neuroblastoma and osteogenic sarcoma. 

---