The nurse is aware that the following findings would be further evidence of a urethral injury in a male client during rectal examination?
A. A low-riding prostate
B. The presence of a boggy mass
C. Absent sphincter tone
D. A positive Hemoccult
Correct Answer: B. The presence of a boggy mass
When the urethra is ruptured, a hematoma or collection of blood separates the two sections of the urethra. This may feel like a boggy mass on rectal examination. Rupture of the urethra is an uncommon result of penile injury, incorrect catheter insertion, straddle injury, or pelvic girdle fracture. The urethra, the muscular tube that allows for urination, may be damaged by trauma. When urethral rupture occurs, urine may extravasate (escape) into the surrounding tissues.
Option A: Because of the rupture and hematoma, the prostate becomes high riding. A palpable prostate gland usually indicates a non-urethral injury. Physical examination may reveal blood at the meatus or a high-riding prostate gland upon rectal examination
Option C: Absent sphincter tone would refer to a spinal cord injury. Neurologic causes — Neurologic disorders such as diabetes, multiple sclerosis, and spinal cord injury can decrease sensation and control over the lower digestive tract. Nerve damage during vaginal childbirth can also decrease anal sphincter function.
Option D: The presence of blood would probably correlate with GI bleeding or a colon injury. Extravasation of blood along the fascial planes of the perineum is another indication of injury to the urethra. “Pie in the sky” findings revealed by cystography usually indicate urethral disruption.
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